Clinical Analysis On Penicilliosis Marneffei In Chiledren

OBJECTIVE:To study the clinical characteristics of penicilliosis maerniffei (PSM) in children.METHODS:The clinical data of6PSM patients who was younger than fourteen years old in our hospital from March2003to December2012were retrospectively analyzed, while literature of the disease were reviewed.RESULTS:The patients in our group were all boys, the patients were3years and4moons old(lyear and2moons,9years).The duration of the disease was39(15,120) days. Tow of them infected by human immunodeficiency virus(HIV).one of them got G6PD deficiency. Others had a poor constitution. Weight loss, anemia and lymphadenectasis could be found in all patients.5cases had fever,3cases had cough and hepatomegaly,2cases had skin lesion,1case had splenomegaly,1case had melena.1case had central nervous system symptom. White blood cell(WBC) decreased in the patients with HIV(+), while increase in2patients with HIV(-).4cases (4/6) lymphocyte were decreased. All of the patients had the lymphocyte dysfunction. All cases were defined according to etiology including blood culture4/6(66.7%), bone culture or (and) smear4/5(80.0%).3cases(100.0%) lymph node smear show the PM. All patients got the pathogen positive with two positions. Granuloma and caseous necrosis were the pathological characteristics. The chest radiology in4cases were abnormal, the patchy consolidation in2cases,lymphadenectasis of the hilus pulmonis and mediastinum in2cases.2cases died without anti-fungus treatment and1case gave up treatment.1case treated with Fluconazole,1case treated with Amphotericin B and1case treated with voriconazole after the Amphotericin B was not effective to him. All of them improved.CONCLUSIONS:①children infected with penicillium marneffei occur among the children infected with HIV, the children with underlying diseases or under hypoimmunity. It is still confused how PM infects humanity.②.PM always result in disseminated infection in children. The most common clinical characteristics were anemia, lymphadenectasis, fever, hepatosplenomegaly multiple organ involvement include lung, skin, digestive system, hematological system and central nervous system. But subcutaneous abscess and osteolysis rarely occurs.③The positive etiology may be easier and earlier.④Lymph node pathology is mainly for granulomatous and necrotic, while suppuration is rare.⑤Early diagnosis and early treatment are very important to its prognosis. Otherwise its mortality rate is very high.