非人类免疫缺陷病毒感染儿童马内菲青霉病合并淋巴结结核1例  

Penicilliosis marneffei complicated with lymph node tuberculosis in a non-human immunodeficiency virus-infected child

作　　者：周利君[1] 卢水华[1] 李锋[1] 冯艳玲[2] 

机构地区：[1]复旦大学附属公共卫生临床中心结核科,上海201508 [2]上海市(复旦大学附属)公共卫生临床中心病理科,上海201508

出　　处：《微生物与感染》2015年第1期46-50,共5页Journal of Microbes and Infections

摘　　要：本文报道1例非人类免疫缺陷病毒(HIV)感染儿童马内菲青霉病合并淋巴结结核。患儿2岁11个月,男性,因"发现耳后淋巴结肿大2年余,加重伴反复发热5个月"入院,经多种抗生素治疗无效。抗结核治疗后体温暂时消退,后反复发热。考虑真菌感染,予伏立康唑治疗,病情明显好转,骨髓穿刺培养找到马内菲青霉。患儿随访行淋巴结穿刺确诊淋巴结结核。结合该病例,本文就马内菲青霉病及其合并结核病的特点、临床表现、诊断、治疗等方面进行文献复习,以提高对该病的认识和诊断、治疗水平。A case of penicilliosis marneffei complicated with lymph node tuberculosis was reported. The boy was born in December 2010 and admitted for swollen lymph nodes behind the ear lasting for more than two years and aggravation with recurrent fever for 5 months. The human immunodeficiency virus （HIV） test was negative. He was treated with a variety of antibiotics but ineffective. After administration of anti- tuberculosis drugs, his body temperature temporarily returned to normal, but recurrent fever appeared. We considered the presence of fungal infections and treated him with voriconazole. The condition of the child was improved significantly. The culture of his bone marrow sample turned positive for Penicillium marneffei. The boy was diagnosed lymph node tuberculosis by lymph node biopsy. The clinical presentation, diagnosis and treatment of penicilliosis marneffei complicated with tuberculosis were discussed in the context of the literatures.

关 键 词：马内菲青霉 马内菲青霉病 淋巴结结核 儿童 伏立康唑 

分 类 号：R522[医药卫生—内科学] R725.1[医药卫生—临床医学]