Pulmonary penicillosis marneffei: Report of the first imported case in Canada
Pulmonary penicillosis marneffei: Report of the first imported case in Canada
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马尔尼菲肺青霉病：加拿大首例输入性病例报告
DOI：
10.1007/bf01104271
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发表时间：
1994
期刊：
影响因子：
5.5
通讯作者：
C. Wong
中科院分区：
文献类型：
--
作者：
Dr A. S. Sekhon;L. Stein;A. Garg;W. Black;J. Glezos;C. Wong
一名57岁女性，生于老挝，1989年移民加拿大前曾在泰国居住，就诊时主诉为咳嗽和呼吸困难。胸部x光显示双侧肺部空气积液从患者支气管洗涤液和痰标本中分离出一种具有可扩散红色素的真菌，初步鉴定为马尔尼菲青霉。在37°C时，真菌在脑心脏灌注琼脂上培养时转化为酵母菌。这种培养物的显微镜检查显示酵母细胞通过裂变繁殖。该患者分离物的鉴定为asP。用外抗原试验。患者血清显示特异性抗体为toP。marneffeiantigen。两性霉素B和酮康唑治疗导致临床改善，胸部x线清清，血清转为阴性。本病例是加拿大首例输入性马尔尼菲青霉病的确诊病例。患者分离物对氟康唑、5-氟胞嘧啶、伊曲康唑和咪康唑的最低抑菌浓度分别为12.5、0.39、<0.195和<0.195µg/ml。
A 57-year-old female, born in Laos and who had lived in Thailand prior to immigrating to Canada in 1989, was seen by her physician with a chief complaint of cough and dyspnea. Her chest X-ray showed bilateral pulmonary air fluid levels. A fungus, with a diffusible red pigment, tentatively identified asPenicillium marneffei, was isolated from the patient's bronchial washings and sputum specimens. At 37 °C, the fungus converted to a yeast form when cultured on brain heart infusion agar. Microscopic examination of this culture revealed yeast cells that reproduced by fission. The identity of the patient's isolate was confirmed asP. marneffeiwith an exoantigen test. The patient's serum demonstrated specific antibodies toP. marneffeiantigen. Treatment with amphotericin B and ketoconazole resulted in clinical improvement, clearing of chest X-rays and conversion to sero-negativity. Our case is the first recorded diagnosis of imported penicillosis marneffei in Canada. The minimal inhibitory concentrations recorded for the patient's isolate to fluconazole, 5-fluorocytosine, itraconazole and miconazole were 12.5, 0.39, <0.195 and <0.195 µg/ml, respectively.