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学科主题: 皮肤病与性病学
题名:
艾滋病并发马尔尼菲青霉败血症1例
其他题名: Penicillium marneffei sepsis in an AIDS patient
作者: 黄芩; 李东明; 孙婷婷; 尚盼盼; 葛杰; 付又刚
关键词: 马尔尼菲青霉 ; 败血症 ; AIDS ; Penicillium marneffei ; sepsis ; AIDS
刊名: 中国真菌学杂志
发表日期: 2014
DOI: 10.3969/j.issn.1673-3827.2014.02.010
期: 2, 页:99-101
收录类别: 中国科技核心期刊 ; CSCD
文章类型: Journal Article
摘要: 目的:报道1例马尔尼菲青霉败血症。方法患者男性,39岁,主因“发热伴淋巴结肿大1个月”就诊。进行骨髓瑞士染色、血液接种于有氧及厌氧培养瓶、沙氏培养基培养等检查,并对培养物进行形态学及 rDNA 序列鉴定。结果骨髓涂片见细胞内分隔孢子,3种培养方法均见真菌生长。沙氏培养基上菌落为丝状菌,表面为黄绿色粉末状,背面为红色;脑心浸汁培养基为酵母样菌落,37℃培养受限制。经 DNA 序列分析,与马尔尼菲青霉相似性在100℅,鉴定为马尔尼菲青霉。患者诊断为艾滋病并马尔尼菲青霉败血症,立即给予氟康唑治疗,转入传染病医院后因极度衰弱死亡。结论败血症可作为马尔尼菲青霉病首发症状,临床应予以重视;患者血液极具传染性,应注意隔离;对于有冶游史的不明原因发热患者,注意考虑本病可能,必要时行血液培养及 HIV 检测。 Penicillium marneffei(PM)infection is prevalent in South-East Asia and Southern China,which has been consid-ered an acquired immunodeficiency syndrome(AIDS)-defining disease. In this paper,we describe Penicillium marneffei sepsis in an HIV-infected patient without skin presentation. A 39-year-old man from Guangdong province came to our clinic with 1-month his-tory of fevers and lymphadenectasis. He was found continuously decrease of leukocyte,erythrocyte and thrombocyte. Anti-HIV anti-body screening test and confirmation test both appeared positive. Blood cultures were positive for fungi. Bone marrow biopsy showed intracellular septate spores. The P. marneffei was identified by rDNA PCR. The patient was diagnosed with AIDS and Penicillium marneffei sepsis. He was treated immediately with fluconazole and transferred to the infectious disease hospital. During the follow-up,he died of multiple organ failure. This case suggests that fungemia could be the initial symptom of penicilliosis marneffei,which should be paid enough attention by clinicians. Patient′s blood should be strictly isolated because of its infectivity,and detection of HIV antibody is necessary. The patients with fever of unknown origin and unsafe sex history may be diagnosed as infection of HIV and Penicillium marneffei.
语种: 中文
原文出处: 查看原文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/73056
Appears in Collections:北京大学第三临床医学院_皮肤科_期刊论文

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作者单位: 北京大学第三医院皮肤科,北京,100191

Recommended Citation:
黄芩,李东明,孙婷婷,等. 艾滋病并发马尔尼菲青霉败血症1例[J]. 中国真菌学杂志,2014(2):99-101.
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