9例非HIV感染患者马尔尼菲蓝状菌播散感染的回顾性分析报告

Retrospective analysis of the clinical and laboratory features of 9 disseminated Talaromyces marneffei cases in non-HIV patients

目的通过回顾性分析非艾滋病患者感染马内菲蓝状菌病的临床特点提高对非HIV患者马内菲蓝状菌病的认识。方法分析并总结9例马内菲蓝状菌感染患者的临床表现及实验室检查各项指标。结果 6例无基础疾病,3例有基础疾病,6例患者接受免疫抑制剂治疗。5例患者有骨损坏,2例有皮疹,淋巴结肿大7例,贫血7例,脾增大7例,肝大5例,体重下降5例,6例患者接受抗结核或非结核治疗。最后有6例患者治愈或好转,3例死亡。结论激素或免疫抑制剂的使用是非艾滋病患者感染马内菲蓝状菌的主要原因。非艾滋病患者感染马内菲蓝状菌无特异性的临床表现,易误诊,早期诊断困难,尤其需与结核病等疾病相鉴别。抗真菌治疗与患者的预后有密切的相关性。

Objective This study aimed to enhance diagnoses of the clinical and laboratory features of Talaromyces marneffei（PM）in non-HIV patients.Methods We retrospectively analyzed the medical records and clinical characteristics of 9patients diagnosed with（PM）from January 1,2008 to December 31,2015 in tertiary Hospital.Results There were 3cases with underlying diseases and 6cases without underlying diseases.Six patients had received immunosuppressant therapy before onset.Four patients occurred the bone damage and 2cases had skin rash,swollen lymph nodes in 7cases,weight loss in 5cases,anaemia in 7cases.Six cases accept anti-TB or NTM treatment.Six cases were cured or improved.Conclusion Patients with non-HIV/AIDS infectious PSM having certain common characteristics but with no specificity made early diagnosis difficult.It especially need to be differentiated from diseases such as tuberculosis.Early antifungal therapy is closely related to the correct prognosis of the patients.