论文部分内容阅读
目的:通过分析83例艾滋病合并真菌感染的临床病例,提高对HIV/AIDS早期诊断能力,减少临床误诊。方法:收集HIV感染者83例,均经湖北省疾病控制中心HIV确认试验确诊。分析患者的临床症状、体征及实验室检查,重点观察真菌感染的种类及部位,并进行相应真菌培养及药敏试验。结果:主要全身症状有长期发热、慢性腹泻、咳嗽及进行性消瘦、恶液质等。实验室检查提示所有患者CD4+细胞计数均<200 cell/μL,最低者仅为8 cell/μL。83例中伴有消化道念珠菌感染4例,呼吸道念珠菌感染2例,另有隐球菌脑膜炎4例,卡氏肺孢子虫肺炎4例,肺组织胞浆菌病2例,马尔尼菲青霉菌感染2例。真菌培养及耐药性显示念珠菌对氟康唑类药物已产生一定耐药性。结论:HIV感染者伴口腔念珠菌病的发生表明其已进入AIDS病期,口腔念珠菌病的出现可作为早期发现AIDS的重要临床指症,常伴发于口腔念珠菌感染的其他部位的真菌感染亦为全身免疫功能下降的局部表现。
OBJECTIVE: To improve the early diagnosis ability of HIV / AIDS and reduce the clinical misdiagnosis by analyzing the clinical cases of 83 AIDS-associated fungal infections. Methods: Totally 83 HIV-infected patients were collected and confirmed by HIV confirmation test in Hubei Provincial Center for Disease Control and Prevention. Analysis of clinical symptoms, signs and laboratory tests, focusing on observation of the type and location of fungal infections, and the corresponding fungal culture and susceptibility testing. Results: The main systemic symptoms of long-term fever, chronic diarrhea, cough and progressive weight loss, cachexia and so on. Laboratory tests suggest that all patients have a CD4 + cell count of <200 cells / μL with a minimum of only 8 cells / μL. In 83 cases, there were 4 cases of Candida albicans infection, 2 cases of respiratory Candida infection, 4 cases of Cryptococcus meningitis, 4 cases of Pneumocystis carinii pneumonia, 2 cases of pulmonary histoplasmosis, Penicillium infection in 2 cases. Fungi culture and drug resistance showed Candida fluconazole drugs have some resistance. Conclusion: The incidence of oral candidiasis in HIV-infected patients indicates that it has entered the AIDS stage. The appearance of oral candidiasis can be used as an important clinical indication for the early detection of AIDS, often accompanied by fungi in other parts of oral candidiasis Infection is also a manifestation of a decrease in systemic immune function.