三种方法联合检测在非 HIV 感染儿童马尔尼菲青霉病的临床应用

Clinical Applification of Combined Detection of Pencilliosis Marneffei in a Non-HIV-infected Child

目的：探讨联合检测曲霉菌半乳甘露聚糖、真菌（1-3）-β-D 葡聚糖及血液培养在非 HIV 感染儿童马尔尼菲青霉病的临床应用价值。方法对1例非 HIV 感染儿童马尔尼菲青霉病患儿静脉血进行曲霉菌半乳甘露聚糖及真菌（1-3）-β-D葡聚糖定量检测，同时对患儿静脉血进行血液培养，血培养仪阳性报警后对培养液进行真菌双相培养，肉眼观察菌落形态，显微镜下观察菌体特征。结果曲霉菌半乳甘露聚糖检测结果14.45μg／L；真菌（1-3）-β-D 葡聚糖检测结果77.14 pg／ml；血液培养检出马尔尼菲青霉菌，培养液25℃菌落为菌丝相，沙保氏培养基上有水溶性酒红色色素产生，35℃为酵母相，菌落可见脑回样皱褶，显微镜下菌体见典型的扫帚状分枝和分隔菌丝。结论曲霉菌半乳甘露聚糖、真菌（1-3）-β-D 葡聚糖定量检测联合血液培养，有助于马尔尼菲青霉病的早期诊断及治疗。

Objective To study the diagnostic value of pencilliosis marneffei （PM）in a non-HIV-infected child with the com-bined detection of aspergillosis galactomannan,fungus Glucan（1-3）-β-D and boold culuture.Methods The venous blood specimen from the child was collected for the quantified detection of aspergillosis galactomannan,fungus Glucan（1-3）-β-D. The growth and colonial morphology of fungus was inspected with the positive blood culture and the characteristics of fun-gus smear were observed under microscope.Results The result of aspergillosis galactomannan was 14.45 μg/L and fungus Glucan （1-3）-β-D 77.14 pg/ml.Penicillium marnrffei was identified using blood culture.It was mycelia form under 25℃ and the salouraud medium produced water soluble claret-red pigment produced.It was mycelia form under 35℃ and the colony was gyri creases,the characteristic broom-like hypha and separation hypha could be found under microscope.Conclusion It is effective for the early diagnosis and therapy of PM with the combination detection of aspergillosis galactomannan,fungus Glucan （1-3）-β-D and boold culuture and have better clinical diagnosis value.