一名13岁女孩的播散性组织胞浆菌病：病例报告
Disseminated Histoplasmosis in a 13-year-old girl: a case report.
作者信息
Ubesie A C, Okafo O C, Ibeziako N S, Onukwuli V O, Mbanefo N R, Uzoigwe J C, Bede C, Ibe B C
机构信息
University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria.
出版信息
Afr Health Sci. 2013 Jun;13(2):518-21. doi: 10.4314/ahs.v13i2.45.
BACKGROUND
Disseminated histoplasmosis is a rare fungal infection and most documented cases are in immune-compromised individuals such as those with acquired immuno-deficiency syndrome.
OBJECTIVE
To describe a case of disseminated histoplasmosis in an adolescent girl.
METHOD
We report a case of disseminated histoplasmosis in a 13-year-old adolescent girl. She was admitted for 16 days because of neck masses of 3 years duration, generalized body swelling of 3 months and reduction in urinary output of 2 months. She tested negative for human immunodeficiency virus antibodies.
RESULT
An autopsy was performed because a definitive diagnosis could not be made while the patient was still alive. The autopsy revealed central caseating areas in the lymph nodes and membranoproliferative glomerulonephritis. The periodic acid-Schiff staining technique for tissues showed viable yeast cells suggestive of histoplasmosis. Zeihl-Neelsen's staining for mycobacteria tuberculosis was negative.
CONCLUSION
Undiagnosed case of disseminated histoplasmosis while the patient was alive is being reported in a 13-year-old girl. Disseminated histoplasmosis should be considered as a differential diagnosis of childhood chronic infections and malignancies as in Nigeria.
背景
播散性组织胞浆菌病是一种罕见的真菌感染，大多数有记录的病例发生在免疫功能低下的个体，如获得性免疫缺陷综合征患者。
目的
描述一名青春期女孩播散性组织胞浆菌病的病例。
方法
我们报告一例13岁青春期女孩播散性组织胞浆菌病的病例。她因持续3年的颈部肿块、3个月的全身肿胀和2个月的尿量减少入院16天。她的人类免疫缺陷病毒抗体检测呈阴性。
结果
由于在患者生前无法做出明确诊断，因此进行了尸检。尸检显示淋巴结中有中央干酪样区域和膜增生性肾小球肾炎。组织的过碘酸-希夫染色技术显示有存活的酵母细胞，提示为组织胞浆菌病。结核分枝杆菌的萋-尼氏染色为阴性。
结论
本文报告了一名13岁女孩生前未被诊断出的播散性组织胞浆菌病病例。在尼日利亚，播散性组织胞浆菌病应被视为儿童慢性感染和恶性肿瘤的鉴别诊断之一。
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