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

中国真菌学杂志　 2016, Vol. 11 　Issue (5): 261-264.

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

王澎¹, 翟丽慧², 范洪伟³, 刘正印³, 王瑶¹, 赵颖¹, 肖盟¹, 曾学军⁴, 施举红⁵, 刘鸿瑞⁶, 冯瑞娥⁶, 谢秀丽¹, 徐英春¹

1. 北京协和医院检验科微生物组, 北京 100730;
2. 解放军总医院第一附属医院检验科, 北京 100048;
3. 北京协和医院感染内科, 北京 100730;
4. 北京协和医院普内科, 北京 100730;
5. 北京协和医院呼吸内科, 北京 100730;
6. 北京协和医院病理科, 北京 100730

收稿日期:2016-03-09 出版日期:2016-10-28 发布日期:2016-10-28
通讯作者: 徐英春,E-mail:xycpumch@139.com E-mail:xycpumch@139.com
作者简介:王澎,女(汉族),学士,副主任技师.E-mail:pumch2005@126.com;翟丽慧,女(汉族),本科,检验师.E-mail:fengyeqing2004@163.com

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

WANG Peng¹, ZHAI Li-hui², FAN Hong-wei³, LIU Zheng-yin³, WANG Yao¹, ZHAO Ying¹, XIAO Meng¹, ZENG Xue-jun⁴, SHI Ju-hong⁵, LIU Hong-rui⁶, FENG Rui-e⁶, XIE Xiu-li¹, XU Ying-chun¹

1. Peking Union Medical College Hospital, PUMCH, 100730 Department of Clinical Microbiology Laboratory;
2. Department of Clinical Laboratory, First Hospital Affiliated to the Chinese PLA General Hospital. Beijing 100048, China;
3. Peking Union Medical College Hospital, PUMCH, 100730 Department of Infectious Diseases;
4. Peking Union Medical College Hospital, PUMCH, 100730 Department of Internal Medicine;
5. Peking Union Medical College Hospital, PUMCH, 100730 Department of Respiration;
6. Peking Union Medical College Hospital, PUMCH, 100730 Department of Pathology

Received:2016-03-09 Online:2016-10-28 Published:2016-10-28

摘要/Abstract

摘要：

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。

关键词: 马内菲青霉菌, 非艾滋病患者, 播散真菌感染, 马尔尼菲蓝状菌

Abstract:

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 9 patients diagnosed with (PM) from January 1,2008 to December 31,2015 in tertiary Hospital.Results There were 3 cases with underlying diseases and 6 cases without underlying diseases.Six patients had received immunosuppressant therapy before onset.Four patients occurred the bone damage and 2 cases had skin rash,swollen lymph nodes in 7 cases,weight loss in 5 cases,anaemia in 7 cases.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.

Key words: Penicillium marneffei, non-HIV/AIDS patients, disseminated fungal infection, Talaromyces marneffei

中图分类号:

R519.8

王澎, 翟丽慧, 范洪伟, 刘正印, 王瑶, 赵颖, 肖盟, 曾学军, 施举红, 刘鸿瑞, 冯瑞娥, 谢秀丽, 徐英春. 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[J]. 中国真菌学杂志, 2016, 11(5): 261-264.

WANG Peng, ZHAI Li-hui, FAN Hong-wei, LIU Zheng-yin, WANG Yao, ZHAO Ying, XIAO Meng, ZENG Xue-jun, SHI Ju-hong, LIU Hong-rui, FENG Rui-e, XIE Xiu-li, XU Ying-chun. Retrospective analysis of the clinical and laboratory features of 9 disseminated Talaromyces marneffei cases in non-HIV patients[J]. Chinese Journal of Mycology, 2016, 11(5): 261-264.

[1]	周怡宏, 鲁雁秋, 陈耀凯. 艾滋病合并马尔尼菲蓝状菌的诊治现状及研究进展[J]. 中国真菌学杂志, 2019, 14(5): 308-312.
[2]	魏金瑛, 欧阳沿音, 蔡双启, 梁浩, 曹存巍. 伏立康唑治疗播散性马尔尼菲蓝状菌病临床分析[J]. 中国真菌学杂志, 2017, 12(2): 92-97.