马尔尼菲青霉菌感染临床分析

Clinical study on Penicilliosis marneffeiinfections

目的目的探讨马尔尼菲青霉菌病(PSM)的流行病学及临床特点。方法回顾性分析2007年1月-2011年12月医院收治的54例确诊为马尔尼菲青霉菌(PM)感染患者的临床资料。结果 54例PSM患者基础疾病分别为46例HIV感染、4例肾脏疾病、3例淋巴系统疾病、1例系统性红斑狼疮;2007-2011年医院198 286例患者送检的标本中旱季检出HIV感染332例,合并PM感染13例,阳性率3.91%,雨季检出358例,合并PM感染33例,阳性率9.22%,HIV感染无季节性,差异无统计学意义,但HIV感染合并PSM在雨季与旱季相比,差异有统计学意义(P<0.01);PM感染呈多部位播散感染,临床表现有发热、贫血、肝脾肿大、浅表淋巴结肿大、皮疹等症状。结论 PM是广西地区HIV感染患者主要条件致病菌之一;PSM发病有明显季节性,以雨季为主;PSM临床表现无特异性,临床应注重对患者标本的培养,做到早诊断、早治疗。

OBJECTIVE To explore the epidemiological and clinical features of Penicilliosis marneffei mycosis （PSM）. METHODS The clinical data of 54 cases of patients who were diagnosed as the P. marneffei infections from Jan 2007 to Dec 2011 were retrospectively analyzed. RESULTS Of 54 cases of patients infected with P. rnarneffei, there were 46 cases with HIV infections, 4 cases with renal disease, 3 cases with lymphatic system disease and 1 case with systemic lupus erythematosus. In the dry season, there were 332 cases of patients with HIV infections and 13 （3.91%） cases complicated with P. marneffei. In the rainy season there were 358 cases and 33 （9.22%） cases complicated with P. marneffei infections, the HIV infections did not change with the season, the difference was not statistically significant （P〈0. 001）, however, as compared with the rainy season and the dry season, the difference in the HIV infection complicated with P. rnarneffei infection was statistically significant （P%0.01）. The P. rnarneffei infections presented as disseminated infections of multiple sites. The fever, anemia, splenomegaly and skin rashes were the main clinical manifestations. CONCLUSION The P. marneffei is one of the most prevalence opportunistic pathogens causing HIV infections in Guangxi. The P. marneffei infection is significantly characterized by season, especially in rainy season. The P. marneffei has no typical clinical manifestations, therefore, the great attention should be paid to the culture of specimens, and it is necessary to diagnose and treat in the early stage.