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Objective To understand the clinical characteristics and changes in laboratory indicators of patients died of visceral leishmaniasis (VL).Methods Clinical data of 4 patients died of VL in Beijing Friendship Hospital from January 2013 to June 2018 were analyzed, differences in laboratory indicators were compared.Results Disease course of 4 cases of VL ranged from3 to 12 months, all patients had multiple organ damage, including 3 cases with hepatomegaly and splenomegaly, 2 cases with central nervous system damage.IgG antibodies of leishmania were positive in 4 patients, Leishman-Donovan body was found in bone marrow smears.Routine peripheral blood test results in 4 patients decreased significantly, albumin decreased significantly and globulin increased;level of serum sodium ion in 4 patients was lower than 135 mmol/L.Conclusion Long disease course, multiple organ damage, involvement of central nervous system, significant reducing in peripheral blood routine test results, hypoproteinemia, and hyponatremia in patients with VL all indicate poor prognosis and high mortality.
RESUMO
Objective To analyze the epidemiologic features of Pneumocystis pcumonia (PCP) among non-HIV infected patients in China. Methods Sputum or bronchoalveolar lavage fluid (BALF) specimens obtained from 851 pneumonia patients without HIV infection from Jan. 2006 to Oct. 2008 were detected, using PCR and Gomori' s methenamine silver (GMS) stain for Pneumocystis jirovecii. Results Of the 615 sputum specimens, P.jirovecii positive rates of PCR and GMS stain were 20.3% and 10.2% respectively (P<0.05). Of 236 BALF specimens, P. jirovecii positive rates of PCR and GMS stain were 32.6% and 25.5% respectively (P0.05). Of the total 851 pneumonia cases, 123 (14.5%) were GMS positive for P.jirovecii cyst and 202 cases (23.7%) were PCR positive for P. jirovecii DNA. In those immuno-suppressed patient group including patients with connective tissue diseases, organ transplant recipients, nephrotic, hematologic diseases and malignant tumor, P. jirovecii positive rate appeared the highest, 28.2% for GMS stain and 39.4% for PCR. There were also PCP patients in the immuno-competcnt pneumonia patient groups including senile patients with chronic diseases and patients without clear predisposing immuno-deficiencies. The positive rates of P. jiroveeii GMS were 8.7% and 10.9% , respectively and 17.5% and 19.6% for P. jiroveeii under PCR.Conclusion PCR assay seemed sensitive for the detection of P. jirovecii in the sputum specimens and could be used for screening PCP patients without HIV infection. Our data showed that there was high risk of PCP in non-HIV infected patients in China.