第481例——发热、皮疹、咳嗽  

The 481st case:fever,rash,and cough

作　　者：郭伏平[1] 张聪丽[2] 卢萌 钱易婍 刘正印[1] 李太生[1] Guo Fuping;Zhang Congli;Lu Meng;Qian Yiqi;Liu Zhengyin;Li Taisheng(Department of Infectious Diseases,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Hematology,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Clinical Medicine,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院/北京协和医学院/北京协和医院感染内科,100730 [2]中国医学科学院/北京协和医学院/北京协和医院血液科,100730 [3]中国医学科学院/北京协和医学院临床医学系,100730

出　　处：《中华内科杂志》2020年第12期1009-1012,共4页Chinese Journal of Internal Medicine

摘　　要：马尔尼菲蓝状菌感染在慢性活动性EB病毒(EBV)感染患者中少见。本例老年男性,以慢性发热、多形性皮疹、咳嗽为主要表现,EBV DNA阳性,并继发噬血细胞综合征,重复皮肤组织培养和病理可见马尔尼菲蓝状菌。临床诊断为慢性活动性EBV感染、继发噬血细胞综合征、马尔尼菲蓝状菌感染,经糖皮质激素及抗真菌治疗后病情好转。通过本病例的分析,增加临床医生对慢性活动性EBV感染合并马尔尼菲蓝状菌感染的了解。Talaromyces Marneffei infection is rarely reported in patients with chronic active Epstein-Barr virus(EBV)infection.We reported an old man with chronic fever,pleomorphic rash,cough,EBV viraemia,and secondary hemophagocytic syndrome.Repeated histological biopsy and culture of skin lesions revealed Talaromyces Marneffei.This patient was diagnosed as chronic active EBV infection,and Talaromyces Marneffei infection.After treated with glucocorticoid steroids and anti-fungal therapy,the patient finally recovered.EBV infection is usually seen in immune compromised patients,who are susceptible to opportunistic pathogens rarely as Talaromyces Marneffei in this case.

关 键 词：感染 EB病毒 马尔尼菲蓝状菌 

分 类 号：R519[医药卫生—内科学] R511[医药卫生—临床医学]