艾滋病伴播散型马尔尼菲青霉菌感染检测分析  

Laboratory detection of Penicillium mameffei disseminated Infection in AIDS patients

作　　者：吕小林[1] 谢福源[1] 万腊根[1] 

机构地区：[1]南昌大学第一附属医院检验科,江西南昌330006

出　　处：《中国热带医学》2012年第8期925-927,共3页China Tropical Medicine

摘　　要：目的评价艾滋病(AIDS)患者合并播散型马尔尼菲青霉菌感染的早期诊断方法。方法运用淋巴结穿刺、骨髓涂片及骨髓病理三种检测方法观察马尔尼菲青霉菌在细胞内外的形态特点;抽取患者血液、骨髓进行真菌培养,分别观察25℃和37℃条件下马尔尼菲青霉菌在马铃薯葡萄糖琼脂培养基上生长情况及菌落形态,并作乳酸酚棉兰染色于显微镜下观察菌体形态特征。结果细胞学结果:在部分单核巨噬细胞或其它组织细胞胞浆内外可见少量呈团分布,大小不一,呈圆型、椭圆型、腊肠形,有1-3个紫红色小核,胞浆较丰富,呈淡兰色病原体;培养特点及显微镜下形态特征:马尔尼菲青霉菌在25℃条件下为青霉相,菌落生长较快,产生玫瑰红色素,镜下可见无色透明分隔菌丝、帚状枝、单链分生孢子等。37℃条件下为酵母相,菌落生长非常缓慢,呈酵母样型,湿润不产色素,显微镜下特征为圆形、椭圆形或长形酵母样菌体,可见关节孢子。结论细胞形态学检测有助于播散型马尔尼菲青霉菌感染的早期诊断。Objective To evaluate the diagnosis method of Penicillium mameffei Disseminated Infection with AIDS in the early stage. Methods Lymph-node aspirate, bone marrow smear and pathologic examination were used to observe the morphology of Penicillium Marneffei intracellular as well as extra cellular;Penicillium mameffeis from peripheral blood and bone marrow of patients were cultured on potato dextrose agar at 25 ℃ and 37 ℃ respectively, observing their growth and colonial morphology, and analyzing their morphology characteristics under light microscopy by using lacto-phenol cotton-blue staining. Results Cytological feature： a small amount of pathogens were disseminated in some mononuclear phagocyte and other histocyte or extraceUular, which were round, oval and botuliform,not of uniform size with 1-3 small amaranth nuclei, abundant light blue cytoplasm. Cultural characteristics and microscopic morphology：Cultured at 25 ℃ ,PeniciUium mameffei looked mould-like which grew rapidly with rosy pigment and showed transparent septate hyphae, penicillus as well as conidiophores under light microscopy; cultured at 37 ℃ ,Penicillium mameffei looked yeast-like which grew very slowly, moistly with no pigment and showed round, oval and elongated yeast-like cells or visible arthrospore under light microscopy. Conclusion cytomorphology play a key role in early diagnosis of Penicillium mameffei Disseminated Infection.

关 键 词：艾滋病 马尔尼菲青霉菌 感染 

分 类 号：R512.91[医药卫生—内科学]