20例马尔尼菲篮状菌病患者的临床特征回顾性分析OA

Objective To analyze the clinical characteristics of talaromycosis marneffei(TSM),and to provide the basis for the diagnosis and treatment of this pathogen.Methods Clinical information of twenty patients diagnosed with TSM in Xiangxi Autonomous Prefecture People's Hospital from January 2020 to September 2022 was collected,and clinical data such as underlying diseases,clinical symptoms,laboratory examination and imaging examination results,treatment and disease outcomes of patients were analyzed.Results Among the 20 patients with TSM,19 of them were HIV carriers and the main symptoms were fever,anemia,cough and sputum,rash,shortness of breath,lymphadenopathy,weight loss and so on.The blood routine showed white blood cells,red blood cells and platelets were all decreased.C-reactive protein increased in 20 patients and procalcitonin increased in 19 patients.CD4+T lymphocyte decreased in 13 patients.G test was performed in 11 patients with a positive rate of 54.5％(6/11),and GM test was performed in 8 patients with a positive rate of 87.5％(7/8).Chest CT examination showed lung infection,mediastinal lymphadenopathy,micronodules,patchy opacities,small bilateral pleural effusions.Twelve patients received sequential therapy primarily with voriconazole,and two patients received antifungal therapy with amphotericin B.Seven patients were discharged from hospital with improved symptoms,9 cases were discharged automatically due to economic and personal reasons.Two patients were transferred to a higher level hospital for continued treatment,and two patients died.Conclusion T.marneffei infection has no specific clinical manifestations.Some patients are complicated with underlying diseases related to immunocompromise,making diagnosis difficult.Clinicians should enhance awareness of this pathogen and improve laboratory detection capabilities to achieve early diagnosis and treatment.