HIV阴性与HIV阳性的马尔尼菲蓝状菌病患者临床特点分析

Retrospective Analysis of Talaromyces Marneffei Infection in Patients with or Without HIV Infection

目的分析比较HIV阴性与HIV阳性的马尔尼菲蓝状菌病的临床特点。方法回顾性分析南方医院经真菌培养或病理确诊为马尔尼菲蓝状菌病的住院患者临床特点。结果共收集HIV阳性18例,HIV阴性11例。马尔尼菲蓝状菌病患者以男性多见,临床表现主要为发热,咳嗽、咳痰,皮疹或皮下结节/脓肿,实验室检查多有白细胞升高、贫血、低蛋白血症。胸部影像学特点表现为斑片样浸润影、胸腔积液等。两组间比较,HIV阴性组患者年龄较大,白细胞计数更高及CD4^+T细胞百分比较高,痰培养阳性率更高,影像学上肺间质纤维化较HIV阳性组多见。结论 HIV阳性与HIV阴性的马尔尼菲蓝状菌病临床特点部分相似但仍有不同,HIV阴性组感染表现更为严重。

Objective To analyse the clinical characteristics of Talaromyces Marneffei（T.marneffei） infection in patients with or without HIV. Methods The inpatients diagnosed with T. marneffei infection from 2006 to 2017 at Nanfang hospital were analyzed. Results A total 18 HIV seropositive and 11 HIV seronegative patients with T. marneffei infection were collected,the majority of which were male patients.Clinical manifestation included pyrexia,cough,cutaneous lesions,hepatosplenomegaly,lymphadenopathy; laboratory abnormal was anemia,hypoproteinemia,high CRP and PCT. Radiological findings included patchy shadows and pleural effusion.In contrast to the HIV seropositive cohort,the HIV seronegative had older age,higher white cell and high percentage of CD4,higher fungal yield and interstitial lung fibrosis. Conclusion The clinical characteristics of T. marneffei infection in both HIV seropositive and HIV seronegative cohort are similar,but the latter has more se-vere clinical manifestations.