Liao Xiaomei, Ran Yuping, Chen Huijiao, Meng Wentong, Xiang Bing, Kang Mei, Xiong Zhiyu, Zhuang Jie, Peng Xuemei, Deng Chengqi, Li Gandi, Liu Weiping
First University Hospital of West China University of Medical Sciences. Chengdu 610041, China.
Zhonghua Yi Xue Za Zhi. 2002 Mar;82(5):325-9.
To explore the clinical and laboratory features of disseminated Penicillium marneffei infection in patients with AIDS.
The HIV antibody in serum was assayed by both enzyme immunoassay (EIA) and Western immunoblot (WIB) methods. Morphology of the pathogenic fungus in smear and biopsy specimens of bone marrow was observed. The fungus was isolated from the patient's skin lesion and inoculated into the abdominal cavities of 2 rats and 2 mice. Twenty days later the rats and mice were killed and their viscera were taken out. Blood from the organs were cultured in Sabourand glucose agar at 25 degrees C and 37 degrees C. The colonies were observed. The morphology of the fungus was observed by microscopy and scanning electron microscopy.
The most common clinical manifestations of Penicilium marneffei infection were fever, weight loss, anemia, papular skin lesion, hepatosplenomegaly, and lymphadenectasis. Yeast-like cells were found in the culture at 37 degrees C or in tissues. The fungi outside the host cells were elongated, often curved, sausage-like and with clear central septi. When cultured at 25 degrees C, the fungus was mycelia-like and produced a characteristic red pigment, diffusing into the medium.
Disseminated Penicilliosis marneffei is one of the most important opportunistic infections in patients with AIDS in Southeast Asia and the southern part of China. Since there is no specific clinical manifestation for Penicillium marneffei infection, it is often misdiagnosed. Definite diagnosis requires culture of the pathogenic fungus from clinical specimens. The fungus is thermally dimorphic, produces red pigment, and is sausage-form with clear central septum outside the host cell. Amphotericin B and itraconazole are effective in treating Penicilliosis marneffei.
探讨艾滋病患者播散性马尔尼菲青霉感染的临床及实验室特征。
采用酶免疫测定法（EIA）和免疫印迹法（WIB）检测血清中的HIV抗体。观察骨髓涂片和活检标本中致病真菌的形态。从患者皮肤病变处分离出真菌，接种于2只大鼠和2只小鼠的腹腔。20天后处死大鼠和小鼠，取出内脏。取器官血液在25℃和37℃的沙氏葡萄糖琼脂培养基上培养，观察菌落。通过显微镜和扫描电子显微镜观察真菌形态。
马尔尼菲青霉感染最常见的临床表现为发热、体重减轻、贫血、丘疹样皮肤病变、肝脾肿大和淋巴结肿大。在37℃培养物或组织中发现酵母样细胞。宿主细胞外的真菌呈细长形，常弯曲，呈腊肠样，中央有清晰的隔膜。在25℃培养时，真菌呈菌丝样，产生特征性红色色素，扩散到培养基中。
播散性马尔尼菲青霉病是东南亚和中国南部艾滋病患者最重要的机会性感染之一。由于马尔尼菲青霉感染无特异性临床表现，常被误诊。明确诊断需要从临床标本中培养出致病真菌。该真菌具有温度双相性，产生红色色素，在宿主细胞外呈腊肠形，中央有清晰的隔膜。两性霉素B和伊曲康唑对马尔尼菲青霉病有效。
