Supparatpinyo K, Chiewchanvit S, Hirunsri P, Uthammachai C, Nelson K E, Sirisanthana T
Faculty of Medicine, Chiang Mai University, Thailand.
Clin Infect Dis. 1992 Apr;14(4):871-4. doi: 10.1093/clinids/14.4.871.
From June 1990 to August 1991, 21 patients infected with the human immunodeficiency virus (HIV) presented with systemic mycosis caused by Penicillium marneffei. Between August 1987 and August 1991, only five patients were observed who had P. marneffei infection but not HIV infection. The clinical presentation included fever, cough, and generalized papular skin lesions. For 11 of these 21 patients, the presumptive diagnosis of P. marneffei infection could be made by microscopic examination of Wright's-stained bone marrow aspirate and/or touch smears of skin specimens obtained by biopsy several days before the results of culture were available. Initial clinical response to treatment with either parenteral amphotericin B or oral itraconazole was favorable in most patients. Epidemiological and clinical evidence suggest that this systemic mycosis is caused by an important opportunistic pathogen and that it should be included in the differential diagnosis of AIDS, at least for countries in areas of endemicity, i.e., Southeast Asia and China.
1990年6月至1991年8月，21例感染人类免疫缺陷病毒（HIV）的患者出现了由马尔尼菲青霉菌引起的系统性真菌病。1987年8月至1991年8月，仅观察到5例马尔尼菲青霉菌感染但未感染HIV的患者。临床表现包括发热、咳嗽和全身性丘疹性皮肤损害。在这21例患者中，有11例在培养结果出来前几天，通过对经瑞氏染色的骨髓穿刺液和/或活检获得的皮肤标本涂片进行显微镜检查，即可作出马尔尼菲青霉菌感染的初步诊断。大多数患者对静脉注射两性霉素B或口服伊曲康唑治疗的初始临床反应良好。流行病学和临床证据表明，这种系统性真菌病是由一种重要的机会性病原体引起的，至少在东南亚和中国等流行地区的国家，应将其纳入艾滋病的鉴别诊断。
