摘要
目的了解某院艾滋病(AIDS)合并马尔尼菲青霉菌病(PSM)患者的流行病学特点、临床特征、处理及预后。方法对2008年1月—2011年8月该院艾滋病科AIDS合并PSM的住院患者病历资料进行回顾性研究。结果共收集33例AIDS合并PSM患者资料,其中54.55%的患者发病前一直居住于湖南,45.45%的患者来源于或曾经去过广东、广西、云南、福建省等传统马尔尼菲青霉菌(PM)疫区。该病最常见的临床症状、体征为以高热为主的发热(96.97%)、贫血(93.94%),其次为咳嗽(66.67%)、脾大(63.64%)、皮疹(57.58%),亦有淋巴结大(39.39%)和腹泻(33.33%)等症状。所有患者CD4+T淋巴细胞计数均<200/mm3,其中25例(75.76%)<50/mm3,7例介于50～100/mm3,1例>100/mm3。给予两性霉素B和伊曲康唑治疗,总治愈好转率为84.85%。结论对AIDS患者,根据其流行病学及临床特征和血培养PM阳性结果早期诊断PSM,积极治疗,能取得满意疗效。
Objective To evaluate the epidemiology, clinical features, treatment and prognosis of Penicilliosis marneffei （PSM） complicated in patients with acquired immunodeficiency syndrome （AIDS） in a hospital. Methods Clinical data of AIDS inpatients with PSM between January 2008 and August 2011 were studied retrospectively. Results Clinical data of 33 patients were collected. Before the onset of disease, 54. 55% of the patients had been living in Hunan, 45.45% came from or have ever been to Penicillium marneffei （PM） endemic areas of Guangdong, Guangxi, Yunnan, and Fujian. The major clinical manifestations were fever （96. 97%）, anaemia （93.94%）, cough （66. 67%）, splenomegaly （63.64% ）, skin rash （57. 58% ）, lymphadenectasis （39：39%） and diarrhea （33.33%）. CD4 ＋ T lymphocyte count of all patients were 〈200/mm3 , and the number of the patients with CI）4 ＋ count in 100 - 200/mm3,50- 100/mm3 and 〈50/mm3 ranges were 1,7 and 25, respectively. After treated with amphotericin B and/or itraconazole, the total cure and improvement rate was 84. 85%. Conclusion With regard to PSM complicated in AIDS patients, early diagnosis and prompt treatment can achieve ideal therapeutic effet.
出处
《中国感染控制杂志》
CAS
2012年第6期413-416,共4页
Chinese Journal of Infection Control
关键词
艾滋病
人免疫缺陷病毒
马尔尼菲青霉菌病
马尔尼菲青霉菌
真菌
流行病学
acquired immunodeficiency syndrome
human immunodeficiency virus
Penicilliosis marneffei
Penicillium marneffei
fungus
epidemiology
