人免疫缺陷病毒抗体阴性播散性非结核分枝杆菌病合并马尔尼菲青霉菌病一例并文献复习

Nontuberculous Mycobacteria Associated with Penicilliosis Marneffei Infection in A Human Immunodeficiency Virus-negative Patient:Report of One Case and Literature Review

非结核分枝杆菌(NTM)感染多见于免疫功能损伤的患者。马尔尼菲青霉菌(PM)是一种温度双向型真菌,主要流行于东南亚各国及我国南方地区,常见于人类免疫缺陷病毒(HIV)感染者,非HIV感染者合并两者感染罕见。北京协和医院收治了1例非HIV感染播散性NTM病合并PM病中年男性患者,广西人,临床表现为腹痛、全身淋巴结肿大、体质量下降、发热、骨痛,HIV抗体阴性,血培养NTM阳性,肱骨穿刺组织培养PM阳性,给予抗NTM及伊曲康唑治疗,随诊2年,临床表现良好。

Disseminated nontuberculous mycobacterial(NTM) infection occurs mostly in immunocompromised hosts.Penicilliosis marneffei(PM) is a unique dimorphic fungal infection endemic in Southeast Asia.It is one of the commonest opportunistic infections among human immunodeficiency virus(HIV)-positive patients.There are rare reports about NTM associated with PM infection in non-HIV-infected individuals.Peking Union Medical College Hospital diagnosed a 45-year-old male patient who came from Guangxi Province.He complained of abdominal pain,generalized lymphadenopathy,weight loss,fever,and upper limb pain at presentation.He was HIV-negative,blood culture was positive for NTM,and the result of humerus specimen culture was PM.After treatment with anti-NTM drugs and itraconazole,his clinical status was improved.He remained symptom-free during the 2-year follow-up.