ABSTRACT
Objective To investigate the clinical characteristics and imaging manifestations of AIDS complicated with disseminated Penicillium marneffei (PM) infection. Methods A total of 12 patients with AIDS complicated with disseminated PM infection were collected and the symptoms, signs, laboratory examination results and image manifestations of these patients were analyzed retrospectively. Results (1) The diagnosis of PM infection in all the 12 cases were confirmed by peripheral blood culture.All the 12 cases (100％) had irregular fever (38-41 ℃) and enlarged lymph nodes, 8 cases (66％) had skin rashes; 8 cases (66％) had hepatomegaly; 9 cases (75％) had splenomegaly while 8 cases (66％) had anemia. (2) Imaging manifestation: Five cases manifested bilateral pulmonary disseminated miliary nodular shadows or lattice signs; 1 case showed enlarged hilar lymph node and 2 zases showed patchy shadow with pleuritis. One case presented sub-pleural curve line shadow at the posterior part of the right lower lung,and adhesion between the intestinal wall and intestinal mesentery in mass form in the abdomen by CT examination. Conclusion Patients suffering from AIDS (CD4T lymphocytes ＜50/μ L) with impaired immunity might be susceptible to complication of disseminated PM infection, which presents mainly damage of multiple organs and symptoms such as fever; enlargement of liver,spleen and lymph nodes, as well as specific skin maculopapular rashes. Imaging manifestations in the lungs were revealed as miliary nodular shadows and lattice-like shadows. Intensified abdominal CT might reveal presence of several enlarged postperitoneal lymph nodes and intestinal adhesion in shape of cakes.
ABSTRACT
Objective To explore the clinical and laboratory feature of disseminated Penicillium marneffei(PSM) infection in patients with AIDS and to analysis treatment and prognosis. Methods Study clinical data of eight case with PSM infection in patients with AIDS in our hospital from 1999 were definite diagnosed PSM infection in patients with AIDS. Results (1)Eight patients including five females, at a mean age of 26～53, suffered from the diseases for a period of 1～4 months;(2)The most common clinical presentations include fever, stomatomycosis, lymphadenectasis papular skin lesion, anemia, abdominal pain, hepatomegaly, Plenomegaly, Herpes progenitalis, Subcutaneous nodule, Pleural effusion, bad bone ache. Laboratory examination showed elevated hepatic enzymes,coagulated dysfunction,hemocytopenia. Chest X-ray showed nonspecific include bilateval interstitial or alveolar. (3) Fungus cultured: yeast like cells were found in the culture at 37℃ or in tissues. The fungi outside the host cells were elongated, often curved, Sausage like and with clear cemral septate. When cultured at 25℃,the fungus was mycelia-like and produced a characteristic red Pigment, diffusing into the medium. (4) CD4 cell count was reduced significantly, HIV-RNA was high.(5)Mortality was high. Conclusions Definite diagnosis of disseminated Penicillium marneffei requires culture of the pathogenic fungus from clinical specimens. No specific clinical manifestation for Penicillum marneffei infection was found and Amphotericin B are effective in treating penicillosis marmeffei.