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Acquired immunodeficiency syndrome associated disseminated Penicillium Marneffei infection:report of

时间:2006-07-14 17:17:49  来源:  作者:

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  Mycological examination

  The Bac/T Alert 120 type blood culture apparatus was adopted;5 ml of peripheral blood were taken from patients at the time of onset of fever,the blood samples were subjected to aerobic and anaerobic bacterial culture for 7 days at 37℃. Once the Gram stain revealed presence of fungus,then light illumination culture under 25℃ and photophobic culture under 37℃ were practiced separately,and microscopic examination was done to confirm the shape of the fungi.

 

  Imaging examination

  All the 8 cases were taken regularly X-ray plates of the chest and abdomen,while simultaneous multilayer spiral CT examination for chest or abdomen was done in 3 cases focusing on the imaging manifestations for the chest or abdomen.

 

  RESULTS

  Diagnoses of all the 8 cases with AIDS complicated by disseminated PSM had been confirmed by peripheral blood culture,4 of them had been further confirmed by bone marrow smears examination with both bone marrow mycological culture and DNA detection (Figs.1,2). Sputum examination for the presence of acid-fast bacilli (AFB) showed all 8 cases is negative of AFB. In addition,both Mycobacterium tuberculosis culture and PPD skin test were also negative in all 8 cases.

 

  Bone marrow smear culture

  Three of the 8 cases had blood culture twice and 5 cases had three times culture. Four cases had bone marrow smear and bone marrow culture for 1 time in the meantime. All tests confirmed the diagnosis of PSM. Bone marrow smears showed an active proliferation of the granulocytes,all PM in normal shape and proportion was seen inside and surrounding the macrophagocytes with round or elliptical shape which was distributed in sporadic or mass manner. Bodies of extra-cellular of PM was relatively longer with round and blunt ends and slightly curved like a sausage with their diameters of 1-8μm (Fig. 3).

 

  CD4+ T lymphocytes and peripheral blood cell

  All 8 cases showed CD4+ T lymphocytes number was less than 50/ml,6 cases was within 25/ml,and 1 case almost 0/ml. RBC count of all 8 cases was (2.01-4.24)×1012/L(3.25±0.74),blood hemoglobin 39-125g /L(88.5±27.13). WBC count was (1.51-13.94)×109/L(5.37±4.56),and granulocyte count was (80.09±4.06)%(74.5-86.3).

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