8例HIV阴性马尔尼菲篮状菌病的临床特征
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广西壮族自治区民族医院检验科, 广西 南宁 530001

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梁小英  E-mail: 13768813508@163.com

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R519

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Clinical characteristics of 8 cases of HIV-negative Talaromycosis
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Department of Laboratory Medicine, Guangxi Zhuang Autonomous Region Nationality Hospital, Nanning 530001, China

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    摘要:

    目的 分析HIV阴性马尔尼菲篮状菌病患者的临床特征,提高临床早期诊断水平。 方法 回顾性分析2016年1月—2020年11月广西壮族自治区民族医院收治的8例HIV阴性马尔尼菲篮状菌病患者的临床病历资料。 结果 8例患者中男性6例、女性2例,平均年龄58岁。6例有肺部感染,4例出现高热,3例淋巴结肿大,2例肝脾大,4例低蛋白血症,3例有骨质破坏,2例曾接受抗结核治疗。辅助检查:7例血常规白细胞显著升高,8例血红蛋白均有降低,血沉、C反应蛋白、降钙素原均有不同程度升高。3例患者经两性霉素B或伊曲康唑治疗,症状改善后带药出院维持治疗,2例转上级医院治疗,3例病情严重、多器官衰竭自动放弃治疗出院。 结论 HIV阴性马尔尼菲篮状菌病临床表现无特异性,易漏诊、误诊,病死率高,临床医生应高度重视。

    Abstract:

    Objective To analyze the clinical characteristics of HIV-negative patients with Talaromycosis, and improve the level of early clinical diagnosis. Methods Clinical data of 8 HIV-negative patients with Talaromycosis in Guangxi Zhuang Autonomous Region Nationality Hospital from January 2016 to November 2020 were analyzed re-trospectively. Results Among the 8 patients, 6 were males and 2 were females, with an average age of 58 years. 6 patients had pulmonary infection, 4 had high fever, 3 had lymphadenopathy, 2 had hepatosplenomegaly, 4 had hypoproteinemia, 3 had bone destruction, and 2 had received anti-tuberculosis treatment. Auxiliary blood routine exa-mination showed that white blood cell of 7 cases increased significantly, 8 cases all had decreased hemoglobin, as well as increased erythrocyte sedimentation rate, C-reactive protein and procalcitonin in varying degrees. Three patients got better and discharged with medicine for maintenance treatment after receiving amphotericin B or itracona-zole treatment, 2 cases were transferred to superior hospital for treatment, 3 patients were with severe multiple organ failure, and voluntarily gave up treatment and discharged. Conclusion There is no specific clinical characteristics among HIV-negative patients with Talaromycosis, which lead to missed diagnosis, misdiagnosis and high mortality, clinicians should pay great attention to it.

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引用本文

梁小英,农波,周颖沛,等.8例HIV阴性马尔尼菲篮状菌病的临床特征[J]. 中国感染控制杂志,2021,(11):1047-1050. DOI:10.12138/j. issn.1671-9638.20211002.
Xiao-ying LIANG, Bo NONG, Ying-pei ZHOU, et al. Clinical characteristics of 8 cases of HIV-negative Talaromycosis[J]. Chin J Infect Control, 2021,(11):1047-1050. DOI:10.12138/j. issn.1671-9638.20211002.

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  • 收稿日期:2021-01-04
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  • 在线发布日期: 2024-04-26
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