非艾滋病儿童马尔尼菲青霉菌病3例报告及文献复习  

Clinical analysis and literature review of 3 cases of Penicilliosis marneffei in non-AIDS children

作　　者：罗湘琴 梁英 凌业生 黎雅婷[1] 陈惠芹[1] LUO Xiangqin;LIANG Ying;LING Yesheng;LI Yating;CHEN Huiqin(Department of Pediatrics,the Third Affiliated Hospital,SUN Yat-sen University,Guangzhou 510630,Guangdong,China)

机构地区：[1]中山大学附属第三医院儿科,广东广州510630

出　　处：《临床儿科杂志》2020年第7期550-553,共4页Journal of Clinical Pediatrics

摘　　要：目的总结非艾滋病儿童播散性马尔尼菲青霉菌病(PSM)的临床特点及治疗转归。方法回顾分析3例PSM患儿的临床资料。结果 3例患儿中女1例,男2例,发病年龄分别为5月龄、1岁5月龄、3岁2月龄,均以反复发热伴咳嗽、气促,病情进行性加重,抗感染治疗无效为主要临床特征;肺部CT均显示多发异常密度影;1例患儿处于急性淋巴细胞白血病诱导化疗期,2例为先天性胆道闭锁。2例患儿经血培养及痰培养、1例经血清及肺泡灌洗液病原微生物二代测序确诊。3例患儿经两性霉素B为主的治疗后均好转。结论 PSM可发生在非艾滋病儿童,肺部是主要靶器官;在PSM流行地区,免疫低下儿童应考虑PSM可能,尽早行病原学检查。Objective To analysis the clinical characteristics and therapeutic outcomes of Penicilliosis maneffei (PSM) in 3 non-AIDS children.Methods A retrospective study of the clinical characteristics and treatment results of 3 children with PSM were analyzed.Results There were 1 female and 2 males,with an age of 5 months,1 year and 5 months,3 years and 2 months respectively.All 3 cases were characterized by recurrent fever with cough,shortness of breath,progressive aggravation of the disease,and ineffective of anti-infection therapy.Chest computed tomography (CT) showed diverse manifestations in the lung.One was in the induction remission chemotherapy stage of acute lymphocytic leukemia,other two had congenital biliary atresia.The diagnoses were made by blood culture,sputum culture,or next-generation sequencing (NGS) of pathogen in the serum and bronchoalveolar lavage fluid (BALF).The conditions of 3 cases were improved after amphotericin B-based treatment.Conclusion PSM can occur in non-AIDS children with lung being the main target organ.For immunocompromised children in epidemic areas,clinicians should be aware of PSM and take pathogenic examination early.

关 键 词：马尔尼菲青霉菌 非艾滋病 儿童 

分 类 号：R725.1[医药卫生—儿科]