Wang Mengyan, Zhang Zhongdong, Yan Jun, Shi Jinchuan, Liu Shourong, Wan Hu
Department II of Infectious Diseases, Xixi Hospital of Hangzhou, Hangzhou Sixth People's Hospital, Hangzhou, 310023, People's Republic of China.
Infect Drug Resist. 2021 Mar 29;14:1265-1271. doi: 10.2147/IDR.S300082. eCollection 2021.
(T.M) is a common opportunistic fungus in human immunodeficiency virus (HIV) infection individual. Secondary Evans syndrome in AIDS patients with infection has not been reported before. Here, we described cases related to this comorbidity.
AIDS patients diagnosed with infection from 2016 to 2020 at Xixi Hospital of Hangzhou were included in this retrospective study.
Total 76 AIDS patients with T.M infection were enrolled. The most common symptoms were fever and cough (70/76; 55/76, respectively). 53/76 (69.74%) patients got positive results of direct antiglobulin test. 14/76 AIDS-T.M patients combined with secondary Hemophagocytic lymphohistiocytosis (HLH). Five patients were diagnosed with AIDS-T.M associated Evans syndrome. There were severe inflammatory reaction, liver dysfunction, coagulation dysfunction and immunodeficiency status in AIDS-T.M patients with secondary Evans syndrome. All patients received antifungal therapy and three patients received corticosteroids for Evans syndrome treatment. One patient died due to sepsis.
AIDS-T.M patients with secondary Evans syndrome is extremely rare and we need to be alert to the occurrence of secondary Evans syndrome in AIDS-T.M patients. Clinicians should timely start effective antifungal treatments with suspicious T.M infection in AIDS patients.
荚膜组织胞浆菌（T.M）是人类免疫缺陷病毒（HIV）感染个体中常见的机会性真菌。艾滋病患者合并荚膜组织胞浆菌感染继发伊文氏综合征此前未见报道。在此，我们描述了与这种合并症相关的病例。
本回顾性研究纳入了2016年至2020年在杭州市西溪医院诊断为荚膜组织胞浆菌感染的艾滋病患者。
共纳入76例合并荚膜组织胞浆菌感染的艾滋病患者。最常见的症状是发热和咳嗽（分别为70/76；55/76）。53/76（69.74%）的患者直接抗球蛋白试验结果呈阳性。14/76例艾滋病合并荚膜组织胞浆菌感染患者合并继发性噬血细胞性淋巴组织细胞增生症（HLH）。5例患者被诊断为艾滋病合并荚膜组织胞浆菌感染相关的伊文氏综合征。艾滋病合并荚膜组织胞浆菌感染继发伊文氏综合征的患者存在严重炎症反应、肝功能障碍、凝血功能障碍和免疫缺陷状态。所有患者均接受抗真菌治疗，3例患者接受糖皮质激素治疗伊文氏综合征。1例患者因败血症死亡。
艾滋病合并荚膜组织胞浆菌感染继发伊文氏综合征极为罕见，我们需要警惕艾滋病合并荚膜组织胞浆菌感染患者继发伊文氏综合征的发生。临床医生应对艾滋病患者中可疑的荚膜组织胞浆菌感染及时启动有效的抗真菌治疗。
