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新发传染病电子杂志 ›› 2023, Vol. 8 ›› Issue (1): 35-38.doi: 10.19871/j.cnki.xfcrbzz.2023.01.007

• 论著 • 上一篇    下一篇

艾滋病合并马尔尼菲蓝状菌感染患者胸部CT特征分析

李逸攀, 宋璐, 史延斌, 曾莹婷, 鲁植艳   

  1. 武汉大学中南医院放射科,湖北 武汉 430071
  • 收稿日期:2022-02-13 出版日期:2023-02-28 发布日期:2023-03-30
  • 通讯作者: 鲁植艳,Email:luzhiyan@znhospital.cn
  • 基金资助:
    湖北省自然科学基金(2020CBF693)

Analysis of chest CT of AIDS patients with Talaromyces marneffei infection

Li Yipan, Song Lu, Shi Yanbin, Zeng Yingting, Lu Zhiyan   

  1. Department of Radiology, Zhongnan Hospital of Wuhan University, Hubei Wuhan 430071, China
  • Received:2022-02-13 Online:2023-02-28 Published:2023-03-30

摘要: 目的 探讨艾滋病(AIDS)合并马尔尼菲蓝状菌(TM)感染患者胸部CT表现,以提高对该病的认识及诊断水平。方法 收集武汉大学中南医院2013年1月至2020年8月经过病原学确诊为AIDS合并TM感染患者32例,对上述患者临床及影像学资料进行回顾性分析及总结。结果 患者出现斑片状磨玻璃影/实变影15例(46.9%),其中3例(9.4%)出现以肺门为中心,向外周扩散,对称性分布、大小不等的片状实变影;肺内实性结节17例(53.1%),其中1例出现空洞,结节样肿块3例(9.4%);弥漫性粟粒样病变3例(9.4%);胸腔积液8例(25%);胸膜增厚3例(9.4%)。纵隔内淋巴结肿大20例(62.5%),最大短径范围为13.6~20.4mm。7例(21.9%)患者出现纵隔内淋巴结的明显增多,呈簇状聚集。结论 AIDS合并TM感染患者肺内CT表现多样,部分患者出现粟粒样病变及以肺门为中心,向外周扩散的片状实变影,这两个征象具有一定特征性。同时关注其纵隔肿大淋巴结病变的规律也能为该病提供重要的鉴别诊断价值。

关键词: 艾滋病, 马尔尼菲蓝状菌, 体层摄影术, X线

Abstract: Objective To explore the features of chest computed tomography(CT) in AIDS patients with Talaromyces marneffei(TM) opportunistic infection in order to improve the understanding and diagnosis of the disease. Method A retrospective analysis was carried out on 32 patients who were diagnosed with human immunodeficiency virus (HIV) and Talaromyces marneffei infection by etiology during their hospitalization in Zhong Nan Hospital of Wuhan University from January, 2013 to August, 2020. After the relevant clinical and imaging data being collected, the chest CT sign of the 32 patients were observed. Result Fifteen patients (46.9%) had patchy ground-glass opacity or consolidation, of which 3 patients showed patchy consolidations with scattered and symmetrical distribution ,lesions that were centered on the hilar and spread outwards, 17 patients (53.1%) had nodules ,one case with a cavity,3 patients (9.4%) with nodular bump.3 patients (9.4%) with miliary pulmonary nodules in the lung field, 8 patients (25.0%) had pleural effusions, and 3 patients (9.4%) with pleural thickening. 20 patients (62.5%) had mediastinal lymph node enlargement, and the maximum short diameter range was 13.6-20.4mm. Seven patients (21.9%) had a significant increase in mediastinal lymph nodes, and some of them gathered into clusters. Conclusion The chest CT signs of AIDS patients with Talaromyces marneffei infection are diverse. The patchy consolidation with scattered and symmetrical distribution, which lesions were centered on the hilar and spread outwards, and miliary pulmonary nodules are two characteristic signs. Meanwhile, paying attention to the law of mediastinal lymph node enlargement lesions can also provide important differential diagnostic value for the disease.

Key words: Acquired immunodeficiency syndrome, Talaromyces marneffei, X-Ray computed

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