儿童马尔尼菲青霉菌感染2例临床和病理分析

• 作 者: 邓力 张美德 曾强 叶启慈 江文辉 余嘉璐 李颖杰 高岩
• 机 构: 广州市儿童医院,广州市儿童医院,广州市儿童医院,广州市儿童医院,广州市儿童医院,广州市儿童医院,广州市儿童医院,广州市儿童医院 510120,510120,510120,510120,510120,5
• 出 处: 中国实用儿科杂志
• 发表日期: 2004年04期
• 关键词: 马尔尼菲青霉菌 儿童 免疫缺陷

目的　探讨儿童马尔尼菲青霉菌感染的临床特点和病理特征。方法　通过淋巴结活检和尸体解剖的肺、肝、脾、淋巴结的病理片观察真菌的形态 ;用酶免疫法和免疫印迹法检测病例 1患儿血清人类免疫缺陷病毒 (HIV)抗体 ;用流式细胞仪检测病例 1患儿的CD3、CD4、CD8和CD1 5 + 5 6。结果　例 1为艾滋病合并马尔尼菲青霉菌感染 ,例 2为播散型马尔尼菲青霉菌感染。例 1的CD4显著降低 ,HIV ELISA、免疫印迹法检测阳性 ,淋巴结活检可见马尔尼菲青霉菌的腊肠状细胞和桑葚小体。对例 2进行尸体解剖 ,肝、脾、淋巴结和双肺中均发现青霉菌的典型的腊肠状细胞和桑葚小体。结论　儿童马尔尼菲青霉菌感染是机会性感染 ,主要继发于先天性免疫缺陷和艾滋病 ,早期诊断、早期治疗对预后的影响很大。

Objective To investigate the clinical features and pathological features of penicillium marneffei infection in children. Methods The morphology of fungi was observed by pathological examination of lymph node biopsy and autopsy of lung, liver, spleen and lymph nodes. Serum human immunodeficiency virus (HIV) antibodies of case 1 were detected by enzyme immunoassay and immunoblotting. Flow cytometry Instrument detection cases 1 children with CD3, CD4, CD8 and CD1 5 +5 6. Results Example 1 was HIV / AIDS Penicillium marneffei infection, Example 2 was disseminated Penicillium marneffei infection. CD4 in Example 1 was significantly reduced, HIV ELISA, Western blot positive test, lymph node biopsy can be seen Penicillium marneffei sausage cells and mulberry body. The autopsy of Example 2 was performed and the typical sausage-like cells and mulberry bodies of Penicillium were found in the liver, spleen, lymph nodes and both lungs. Conclusion Penicillium marneffei infection is an opportunistic infection, mainly secondary to congenital immunodeficiency and AIDS. Early diagnosis and early treatment have a great impact on prognosis.