53例艾滋病合并马尔尼菲篮状菌感染患者的临床特点分析

Clinical characteristics of 53 cases of acquired immunodeficiency syndrome infected with talaromyces marneffei

目的研究53例艾滋病伴马尔尼菲篮状菌(TM)感染患者的临床特点。方法回顾性分析53例艾滋病合并TM感染患者的临床资料,总结其临床特点、治疗及转归情况。结果艾滋病合并TM感染患者以男性居多,农村患者多于城镇,大部分患者均经抗病毒治疗。53例患者均存在不同程度发热,咳嗽47例,消瘦39例,乏力29例,皮疹20例;实验室检查显示多数患者白细胞、粒细胞、淋巴细胞、嗜酸粒细胞、血小板减少,中性粒细胞百分比、降钙素原升高及贫血均较多。所有患者血培养均培养出TM。53例患者中,孢子菌肺炎24例应用磺胺甲噁唑治疗,巨细胞病毒感染10例采用更昔洛韦抗病毒治疗,真菌感染47例使用伊曲康唑治疗。23例患者好转出院,28例患者自动出院,2例死亡。结论艾滋病合并TM感染主要表现为发热,还可伴有其他症状,也有血细胞减少及肝功能异常的情况,好发于CD4^(+)淋巴细胞计数较低的患者,两性霉素B静脉滴注效果良好。

Objective To study the clinical characteristics of 53 cases of acquired immunodeficiency syndrome infected with talaromyces marneffei(TM).Methods The clinical data of 53 cases of acquired immunodeficiency syndrome infected with TM infection were retrospectively analyzed,and the clinical characteristics,treatment and outcome were summarized.Results The majority of AIDS patients with TM infection were male,rural patients were more than urban patients,and most of the patients were treated with antiviral therapy.All the 53 patients had fever of different degrees,cough in 47 cases,emaciation in 39 cases,fatigue in 29 cases,and rash in 20 cases;laboratory tests showed that most patients had a decrease in leukocytes,granulocytes,lymphocytes,eosinophils,platelets,and an increase in neutrophil percentage,procalcitonin and anemia.TM was cultured in blood cultures in all patients.Of the 53 patients,24 cases of pneumocystis pneumonia were treated with sulfamethoxazole,10 cases of cytomegalovirus infection were treated with ganciclovir,47 cases of fungal infection were treated with itraconazole.23 patients improved and were discharged,28 patients were discharged spontaneously,and 2 patients died.Conclusion The main manifestation of acquired immunodeficiency syndrome with TM infection is fever,and can be accompanied by other symptoms,as well as hemocytopenia and abnormal liver function,preferably in patients with low CD4^(+) lymphocyte counts,with good results of amphotericin B drip.