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| Clinical analysis of 160 cases of Penicillium marneffei infection |
| ZHANG Dongwei1 LAN Bing1 YE Ping 2 KONG Jinliang 2▲ |
1.Department of Respiratory, Liuzhou People′s Hospital, Guangxi Zhuang Autonomous Region, Liuzhou 545000, China;
2.Department of Respiratory, the First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning 545000, China |
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Abstract Objective To investigate the clinical characteristics and clinical outcomes of 160 cases Zhuang Autonomous Region marneffei (PSM). Methods From January 2003 to December 2015, clinical data of 160 patients with PSM in the First Affiliated Hospital of Guangxi Medical University and Liuzhou People′s Hospital were reviewed and analyzed. Results A total of 160 cases of PSM were diagnosed, including 33 cases of immunocompetent and 127 cases of immunodeficiency. The first clinical manifestations of PSM were fever (92.1%), anemic appearance (89.3%), weight loss (88.1%), fatigue (86.2%), cough (80.0%) , sputum (76.3%), skin lesions (64.3%), superficial lymphadenopathy (61.2%), hepatomegaly (17.5%), chest pain (16.2%), osteoarthritis (15.6%), splenomegaly (12.5%), dyspnea (11.2%). The common detected sites were blood（61.7%），skin lesion secretions smear （59.3%），bone marrow culture (57.1%), skin secretion smear (46.9%), biopsy histopathology (43.5%), bone marrow smear (32.0%), alveolar lavage cultivation (28.3%), sputum (28.7%), sputum smear (19.4%). There were 123 cases with abnormal pulmonary lesions through the first CT scan and the lesions mainly located at the same side or both sides and most of those located in the lower left lobe and right middle lobe, followed by the right lower lobe and the upper right lobe. The focus of the lesion was nodular or mass, followed by the patchy exudative, double diffuse miliary lesions and double lung diffuse ground-glass opacity. After treatment, 82 cases of patients were complete remission or partial remission , 19 cases of progression and 31 cases of death. In the immunized normal group, there were 24 cases of remission, 2 cases of progression and 3 cases of death. While in the immunized damage group were 58 cases of remission, 17 cases of progression and 28 cases of death. The prognosis in the immunized damage group was worse than that of the immunized normal group, with statistically significant difference (χ2=6.732，P ＜ 0.05). Conclusion The clinical manifestations of PSM are complex and diverse, lack of specificity and could involving the whole system. The most commen detected sites are blood, skin lesions, bone marrow.
The chest imaging performance is lack of specificity, The disease relief rate is low and the recurrence rate of death is high. Clinical and bacterial room, radiologists should pay much attention to the clinical characteristics of the disease and the pathogen examination, reduce the risk of recurrence and deterioration of death.
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