Liyan Xi, Changming Lu, Xianyi Zhou, Luxia Wang, Suisheng Xie
Department of Dermatology, The Second Affiliated Hospital, Sun Yat-Sen University, No. 107 West Yangjiang Rd., Guangzhou 510120, China.
Mycopathologia. 2004 Aug;158(2):151-5. doi: 10.1023/b:myco.0000041842.90633.86.
We analyzed the occurrence, clinical and physical features, laboratory findings, diagnostic criteria, reaction to therapy and prognosis of 15 cases Penecilliosis marneffei. Four were localized infection on skin, eleven were systemic infection, all cases were found in Guangdong province of China. We found that males were predominant in infection compared with females in 15 patients, and all patients observed had different occupations. The patients with AIDS as underlying disease were commonly drivers or unemployed. Thirteen of 15 patients had underlying diseases, i.e., connective tissue disease, aplastic anemia, kidney transplant, AIDS. Clinical features showed different symptoms, including weight loss, high fever, skin lesions, and respiratory system symptoms. Seven of 15 patients received antifungal therapy, the remaining eight patients did not receive therapy for different reasons. Nine of the patients died five recovered. Fifteen isolates were cultured from skin lesions, blood, bone marrow, peritoneum dialysis and pleural effusion and were confirmed to be Penicillium marneffei by morphology, thermal dimorphism, pathology and DNA sequence analysis. This report indicates that Penicillium marneffei may exist in nature in Guangdong province of SE China.
我们分析了15例马尔尼菲青霉病患者的发病情况、临床和体征特征、实验室检查结果、诊断标准、治疗反应及预后。其中4例为皮肤局限性感染，11例为系统性感染，所有病例均来自中国广东省。我们发现，15例患者中男性感染多于女性，且所有观察对象职业各异。以艾滋病为基础疾病的患者多为司机或无业人员。15例患者中有13例患有基础疾病，即结缔组织病、再生障碍性贫血、肾移植、艾滋病。临床特征表现为不同症状，包括体重减轻、高热、皮肤损害及呼吸系统症状。15例患者中有7例接受了抗真菌治疗，其余8例因不同原因未接受治疗。9例患者死亡，5例康复。从皮肤损害、血液、骨髓、腹膜透析液及胸腔积液中培养出15株菌株，经形态学、温度双相性、病理学及DNA序列分析确诊为马尔尼菲青霉。本报告表明，马尔尼菲青霉可能在中国东南部广东省的自然环境中存在。
