Résumé
Objective To analyze the incidence of the disease, clinical features, diagnostic criteria, therapy and prognosis of Penicilliosis marneffei found in Guangdong province. Methods To analyze patients data, clinical features, laboratory findings, response to therapy, and prognosis of 15 cases Penicilliosis marneffei found in Guangdong province of China. Results The male was predominant compared with the female (ratio 2 to 1) and without occupational preference, but the patients with AIDS as underlying disease were mostly drivers and the unemployed. Thirteen patients were immunocompromised such as AIDS, connective tissue disease, and kidney transplant. Clinical features showed different manifestations, such as high fever, loss of weight, skin lesion, and respiratory system symptoms. Biopsy of the skin lesion showed PAS stain positive yeast-like, or sausage-form spores. Four patients were localized infection of the skin, eleven patients were systemic infection. Nine patients died, five recovered, 1 patient refused to be treated. Fifteen isolates from different anatomic sites of the patients were identified to be Penicillium marneffei by morphology and dimorphism in the culture, and eleven isolates among these 15 isolates were also confirmed by DNA sequence analysis. Conclusion The incidence rate of Penicilliosis marneffei become higher in the recent years and many patients were accompanied with AIDS in Guangdong province. Attention should be paid to the disease.
Résumé
Objective To investigate the relationship between the concentration of plasma (1→3)-?-D-glucan (?-D-glucan) and deep fungal infection. Methods Thirteen patients were recruited in this study, who were suspected with deep fungal infection. G-test TE reagent for ?-D-glucan measurement was used to detect the plasma (1→3) ?-D-glucan in the patients by using UV-2450 spectrophotometer at 545 nm wavelength. The final concentrations were calculated according to concentration conversion formula. Results Nine of thirteen patients were confirmed as deep fungal infection by positive tissue culture, in whom high concentrations of ?-D-glucan were detected, the highest concentration was 352.94 pg/mL (mixed infection), with a mean value of 203.47 pg/mL. In the other four patients with negative culture, the ?-D-glucan concentration was over 54.40 pg/mL in three patients and 16.16 pg/mL in the another. Our results showed that the sensiti-vity, specificity, positive predictive value and negative predictive value of this test were 92.31%, 100%, 100% and 98.36%, respectively. Conclusion G-test TE method is a simple and rapid test and may be used for the diagnosis of patients with deep fungal infection.