马尔尼菲青霉病8例临床分析  

Clinical analysis of eight cases of Penicillium marneffi infection

作　　者：翟志芳[1] 王莉[1] 周村建[1] 徐艳[1] 杨希川[1] 钟白玉[1] 阎衡[1] 

机构地区：[1]第三军医大学西南医院皮肤科,重庆400038

出　　处：《中国真菌学杂志》2010年第3期162-164,169,共4页Chinese Journal of Mycology

基　　金：重庆市自然科学基金(CSTC;2008BB5291);第三军医大学临床科研基金(SWH2007006)

摘　　要：目的分析总结马尔尼菲青霉病的临床及实验室特征。方法以回顾性分析的方法 ,对我科2003～2009年期间诊治的8名明确诊断为马尔尼菲青霉感染患者的临床特征、皮损组织病理学特点及其皮损组织、骨髓或咽拭子等进行真菌培养的菌落及真菌形态等实验室检查结果进行分析。结果①马尔尼菲青霉感染多发生于HIV感染患者或AIDS患者。②皮损可与全身症状同时或先后出现,皮损表现为淡红色丘疱疹、坏死性丘疹、传染性软疣样丘疹、皮肤溃疡及血痂。③多伴有多系统损害。④37℃培养呈酵母相,25℃呈菌丝相,皮损组织病理可以看到典型的"桑葚样"改变。结论马尔尼菲青霉感染好发于HIV感染患者或其他免疫功能低下的患者,常表现为特征性皮疹,皮损组织、骨髓或分泌物于25℃、37℃真菌培养结合皮肤病理是明确诊断的关键。Objective To analyze the clinical and laboratory features of penicilliosis marneffei （PSM）.Methods Clinical and laboratory features of eight patients with PSM from our department during 2003-2009 were retrospectively analyzed. Results ① Penicillium marneffei infections commonly occurred in HIV-infected patients or AIDS patients.②The skin lesions including red-dish papulovesicles,necrotizing papules,molluscum contagiosum-like papules,ulcers and blood scab and systemic symptoms might appear simultaneously or successively. ③Multiple organs could be involved. ④ Penicillium marneffei showed yeast-phase at 37℃, but mycelial phase at 25℃. Typical ＂ mulberry-like＂ changes were observed histopathologically. Conclusions PSM often occurs in the HIV-infected patients or other immunosuppressive patients. It characteristics of mycology and histopathology is key for diagnosis.

关 键 词：马尔尼菲青霉 马尔尼菲青霉病 皮肤 HIV感染 

分 类 号：R756.6[医药卫生—皮肤病学与性病学]