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合并感染马尔尼菲篮状菌病和卡波西肉瘤的 HIV 感染者 1 例报告

Concurrence of Talaromycosis and Kaposi Sarcoma in an HIV-Infected Patient: A Case Report.

机构信息

Department of Infectious Diseases, Wenzhou Central Hospital, Zhejiang, 32500, China.

出版信息

Curr HIV Res. 2021;19(2):195-198. doi: 10.2174/1570162X18999201105161137.

Abstract

BACKGROUND

Concurrence of talaromycosis, an infection caused by the opportunistic fungal pathogen Talaromyces marneffei and Kaposi sarcoma, a common vascular tumor, is a rare but severe medical condition in patients infected with the human immunodeficiency virus (HIV). Despite poor outcomes, the clinical characteristics and management strategies for HIV-infected patients with comorbid Kaposi sarcoma and talaromycosis have not been well documented.

CASE PRESENTATION

A 33-year-old HIV-positive male patient presented to the Department of Infectious Diseases at Wenzhou Central Hospital with cough, sputum expectoration, hemoptysis, rashes on the feet and violaceous plaques in the oral cavity. Chest computed tomography (CT) showed bilateral nodules, patchy shadows and lymphadenectasis. Skin biopsy and histopathological examination indicated Kaposi sarcoma. T. marneffei was isolated from blood cultures and suggested talaromycosis. The patient's overall conditions significantly improved following initiation of combination antiretroviral therapy (cART) and chemotherapy for Kaposi sarcoma and antifungal treatment for talaromycosis.

CONCLUSION

Severe medical conditions such as Kaposi sarcoma and talaromycosis may coexist in HIV-infected patients and pose an increased risk of mortality. Etiological diagnosis and treatment are the keys to the successful management of HIV-infected patients with these concurrent conditions.

摘要

背景

马尔尼菲篮状菌病(一种由机会性病原体马尔尼菲青霉引起的感染)和卡波西肉瘤同时发生,是人类免疫缺陷病毒(HIV)感染者中一种罕见但严重的医疗情况。尽管预后不佳,但 HIV 合并卡波西肉瘤和马尔尼菲篮状菌病患者的临床特征和管理策略尚未得到充分记录。

病例介绍

一名 33 岁 HIV 阳性男性因咳嗽、咳痰、咯血、足部皮疹和口腔紫色斑块到温州中心医院感染科就诊。胸部计算机断层扫描(CT)显示双侧结节、斑片状阴影和淋巴结肿大。皮肤活检和组织病理学检查提示卡波西肉瘤。从血液培养中分离出马尔尼菲青霉,提示马尔尼菲篮状菌病。该患者在开始接受联合抗逆转录病毒治疗(cART)、卡波西肉瘤化疗和马尔尼菲篮状菌病抗真菌治疗后,整体状况显著改善。

结论

严重的医疗情况,如卡波西肉瘤和马尔尼菲篮状菌病,可能同时存在于 HIV 感染者中,并增加死亡风险。病因诊断和治疗是成功管理这些合并症 HIV 感染者的关键。

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