Clinical Analysis Of 51 Cases Of Penicilliosis Marneffei

Objective To explore the epidemiological and clinical features,therapeutic regimens of Penicilliosis Marneffei(PSM)found in Guangxi province.Methods Through reviewing clinical data of 51 cases with PSM admitted to the first affiliated hospital of Guangxi Medical University from January 2004 to December 2008.Results Among the 51 cases,35 were associated with AIDS, 16 were not associated with AIDS. The most common clinical presentations were fever(96.1%),anemia(82.4%), weightloss(76.5%),skinlesion(68.6%),cough (62.7%),and lymphadenectasis(60.8%).The patients complicated with AIDS presented severe systemic toxic symptoms and disseminated,necrotic skin rashes. Mean CD4+ lymphocyte counts in peripheral blood was 15.25 cells/ul. Most patients had CD4+ lymphocyte counts less than 500 cells/ul(82.5%),and those complicated with AIDS(96.3%) had CD4+ lymphocyte counts less than 50 cells/ul.The abnormal rate of alanine aminotransferase and aspartate aminotransferase of patients complicated with AIDS was higher than that of non-AIDS patients(P<0.05).In different clinical specimens,the highest positive rate was skin biopsy(80%), followed by blood culture(78.8%),bone marrow culture(75%),tissue / secretion culture(66.7%).The efficacy of amphotericin B was better than that of fluconazole(P<0.05).There was no significant difference in cure and improvement rate between patients with and without AIDS(P>0.05). Conclusions Most PSM cases in Guangxi were found in AIDS patient。Common manifestations of PSM are relatively non-specific, the most common clinical presentations were fever,anemia,weight loss, skin lesion, cough, lymphadenectasis, hepatomegaly and splenomegaly. Specific skin rashes were helpful to dagnose PSM.PM was isolated most frequently from skin biopsies,blo- od cultures, bone marrow and tissue / secretion cultures. The efficacy of amphotericin B was better than that of fluconazole.There were some differences between the patients complicated with AIDS and those non-AIDS in the clinical features, laboratory examinations.