摘要
目的探讨艾滋病(AIDS)合并皮肤马尔尼菲青霉感染的临床及实验室特征。方法分析2005年1月至2006年6月本院收治的明确诊断为AIDS合并皮肤马尔尼菲青霉感染的4例患者临床特征;取皮损、血和骨髓分别在25℃和37℃进行真菌培养,观察菌落形态、显微镜下特征;对皮肤活检组织行HE及六胺银染色,观察镜下皮损组织学及马尔尼菲青霉的特征。结果AIDS合并皮肤马尔尼菲青霉感染伴多系统损害,皮损特征:早期表现为淡红色丘疱疹、糜烂性丘疹,继而为坏死性丘疹、传染性软疣样丘疹、皮肤溃疡及血痂。37℃培养呈酵母相,25℃呈菌丝相,皮肤病理活检六胺银染色(+)。使用二性霉素B、伊曲康唑治疗,3例临床症状缓解、皮疹消退出院,1例死亡。结论AIDS合并皮肤马尔尼菲青霉感染皮损特征:坏死性丘疹、传染性软疣样丘疹。皮损25℃、37℃真菌培养结合皮肤病理活检是确诊的关键,二性霉素B、伊曲康唑是目前治疗AIDS合并皮肤马尔尼菲青霉感染的首选药物。
Objective To explore the clinical and laboratory features of MDS-associated skin infection with penicillium mameffei. Method Patients hospitalized between January 2005 to June 2006 were selected for examination in this study. Samples taken from skin lesion,peripheral blood and bone marrow were cultivated at 25~C and 37℃, respectively, for fungal growth. Features of the fungal colonies were examined under microscope. HE and Gomori,Methenamine Silver （GMS） were used for tissue staining. Microscopic examination method was used for histological and microbiological examination. Result Multi-organ damage was observed in AIDS patients with penlcillium mameffei infection. The main features of skin lesions included the appearance of light red papulo vesicle, anabrosis papula, necrotic papula, molluscum contagiosum-like papula, skin ulcer and crust. Dimorphic fungi were observed in the culture and GMS in biopsy are positive. 3 patients recovered from the infection and 1 patient died after the treatment with Amphotercin B and Itraconazole. Conclusion Necrotic papula and molluscum contagiosum- like papula are the major features of skin lesion. Detection of dimorphic fungi and skin biopsy are essential in det＇ming the disease. Amphotercin B and Itraconazole are the choice of drugs for treatment.
出处
《热带医学杂志》
CAS
2007年第2期158-160,F0004,共4页
Journal of Tropical Medicine
基金
广东省科技计划资助项目(No.2006B36030002)
