获得性免疫缺陷综合征合并感染荚膜组织胞浆菌病1例

Diagnosis of acquiredimmune deficiency syndrome with Histoplasma infection:a case report

患者,男,51岁,因发现艾滋病病毒感染16年,发热1个月余入院,主要表现为反复高热,严重黄疸,重度贫血貌,口腔可见少量白斑等。经组织活检、影像学检查、基因测序等确诊为艾滋病合并组织胞浆菌病、嗜血细胞综合征、脓毒症、多浆膜腔积液和重度低蛋白血症,病例复杂危重。予两性霉素B静脉输注,复方磺胺甲恶唑片和拉米夫定/多替拉韦方案,较前好转出院,随访4个月未再次感染。

A 51 years old male patient was admitted to the hospital because of the discovery of HIV-infected for 16 years and fever for more than 1 month,mainly presenting with recurrent high fever,severe jaundice,severe anemic appearance,and a small amount of leukoplakia visible in the oral cavity.After tissue biopsy,imaging examination,gene sequencing,etc.confirmed the diagnosis of acquiredimmune deficiency syndrome combined with histoplasmosis,haemophagocytic syndrome,sepsis,multiple plasma cavities and severe hypoproteinemia,the case was complex and critical.Amphotericin B intravenous infusion,compound sulfamethoxazole tablets and lamivudine/doteravir regimen were given.The patient was discharged from the hospital with a better outcome than before,with no re-infection in 4 months of follow-up.