ABSTRACT
Objective To discuss the clinical features of immunocompetent patients with Penicilliosis marneffei.Methods To analyze and summarize the clinical data of 4 immunocompetent patients with Penicilliosis marneffei.Results Clinical manifestation of patients centered on intermittent slight or mild fever,lymphadenectasis,skin eruptions,osteolytic destruction,anaemia,and leukocytosis.The cultural Penicillium marneffei in specimen such as blood,pus showed a higher positive rate.Amphotericin B and itraconazole was available in treatment.Conclusion Immunocompetent people can be infected by Penicillium marneffei,and they appear nonspecific in clinical manifestation after infection.A timely and effective antifungal therapy can improve the prognosis of patients.
ABSTRACT
Objective To explore the significance of surgical resection for the pineal region tumor,the extent of tumor resection,the surgical approaches and treatment measures of hydrocephalus.Methods Twentythree patients diagnosed of pineal region cancer were recruited for this study.Thirteen patients received ventriculo-peritoneal shunt(V-P),during which 7 cases received intraoperative end-plate colostomy.Two of the 13 cases received a second V-P procedure.Another 13 cases received operation by corpus callosum- septum-Dome Room-the third ventricle approach to remove the tumor; Eight cases underwent the tumor resection by suboccipital supratentorial approach (Poppen approach )and 2 cases underwent the tumor resection by the infratentorial cerebellar approach( Krause approach).Results Total tumor resection was performed in 11 cases,subtotal or major total resection in 8 cases and partial resection in 4 cases.Nine cases underwent postoperative radiotherapy alone,8 receiving radiotherapy plus chemotherapy,and 6 cases receiving neither radiotherapy nor chemotherapy.Two cases died during treatment.Conclusion Though it is not practicable to completely remove the germ cell tumor in patients with relatively large tumors,cerebrospinal fluid circulation pathways should be reestablished,including ventriculo-peritoneal shunt,colostomy from the end of the third ventricle to the end plate.If tumors are not too large,they would be easy to be removed.The effects on the surrounding brain tissue would not be much significant.If the connection of Ⅲ,V ventricles were normal,the patient may not need shunt or colostomy.Radiotherapy and chemotherapy can be given to this kind of patients after the surgery.To improve the efficacy,other types of tumors,expecially the benign tumors,should be totally removed.
ABSTRACT
OBJECTIVE To improve the diagnosis level of Penicillium marneffei culture identification in the grass-roots laboratories.METHODS The patient′s blood or bone marrow were innoculated to BacT/Alert 3D blood culture system.when positive sample was found,the culture fluid and node tissues were smeared to take,Gram stain.The pathogens suchas small long branch,septate hyphae,sausage-shaped cell,were transferred to Colombia blood plate,sand Paul agar and CHROMagar Candida chromogenic culture medium to observe the 25 ℃ and 35 ℃,to observe the colony morphology and cell characteristics.The relevant biochemical reaction tests,were cutler taken.RESULTS The foundation of identifying P.marneffei culture:it is a dimorphic fungus,cultured for fungal phase at 25℃,and for yeast phase at 35℃.Both could produce wine red pigment.Morphology under the microscope:culture had typical broom-shaped sticks at 25℃,and round,oval,blunt and slightly curved at both ends,and sausage-shaped thallus that had horizontal septum.Biochemical results:both could assimilate and ferment glucose to produce acid,urea luciferase positive.Both could be inhibited by Actidione,and couldn′t assimilate fermenting lactose.CONCLUSIONS The appropriate medium for the P.marneffei is Sabourand′s medium.The appropriate stains of the cell morphology and structure are lactic acid cotton blue staining and Gram staining which are suitable for the grass-root level laboratories.