中国人兽共患病学报2025，Vol.41Issue(10)：1081-1088,8.DOI:10.3969/j.issn.1002-2694.2025.00.157
20例非HIV感染播散性马尔尼菲篮状菌病临床特征及转归的分析
Clinical characteristics and outcomes of 20 non-HIV-infected patients with dis-seminated Talaromycosis marneffei
摘要
Abstract
This study analyzed the clinical characteristics,diagnosis,treatment,and outcomes of disseminated Tsalaromycosis marneffei(DTSM)in non-HIV-infected patients.A retrospective analysis was conducted on 20 cases of non-HIV-infected DTSM treated at Guangzhou Chest Hospital between January 2015 and December 2021.Clinical data,including demographic characteris-tics,time to diagnosis,clinical manifestations,comorbidities,treatment details,and outcomes,were collected and analyzed.Among the 20 cases,9 were in males,and 11 were in females;the median age was 46(range:1-70)years.The median time from symptom onset to definitive diagnosis was 12(range:1-24)months,and 16 cases were initially misdiagnosed with mycobacterial disease.More than half the patients exhibited four major clinical features:fever,lymphadenopathy,skin lesions,and bone lesions.Pulmonary imag-ing abnormalities were observed in 19 cases,and an average of(3.6±1.6)lung lobes were involved.The positive detection rate of multi-sample cultures(70%,14/20)was significantly higher than that identified through histopathological examination(25%,5/20)(χ²=8.120,P=0.004).Findings for all five patients with positive next-generation sequencing(NGS)results were further confirmed through pathogen culture or histopathology.After antifungal treatment,14 patients showed clinical improvement and were discharged.In conclusion,non-HIV-infected DTSM is characterized by complex clinical manifestations and extensive pulmonary involvement,thus leading to frequent misdiagnosis and diagnostic delays.Pathogen detection methods,such as multi-sample cultures and NGS,demonstrate superior diagnostic accuracy to histopathological examination.Early identification and standardized antifungal therapy are critical factors in determining patient outcomes.关键词
马尔尼菲篮状菌病/人类免疫缺陷病毒/临床表现/预后Key words
Talaromycosis marneffei/HIV/clinical manifestations/prognosis分类
医药卫生引用本文复制引用
张贤兰,苏宁,李超霞,金韵,黄惠怡,黄智昊..20例非HIV感染播散性马尔尼菲篮状菌病临床特征及转归的分析[J].中国人兽共患病学报,2025,41(10):1081-1088,8.基金项目
广州市医学重点学科(No.2025-2027) （No.2025-2027）
广州市科技计划(No.2023A03J0534) Guangzhou Medical Key Discipline(No.2025-2027) （No.2023A03J0534）
Guangzhou Science and Technology Planning Project(No.2023A03J0534) （No.2023A03J0534）
