宜宾市第五人民医院,四川 宜宾 644000
论文通信作者:余燕(1193784797@qq.com)
收稿:2026-07-01,
修回:2026-08-03,
录用:2026-08-13,
网络首发:2026-08-18,
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余燕,钟梦霞,任宴梅.一例艾滋病合并人鼻病毒与马尔尼菲篮状菌共感染的案例分析[J].数智医学,
余燕, 钟梦霞, 任宴梅. 一例艾滋病合并人鼻病毒与马尔尼菲篮状菌共感染的案例分析[J/OL]. Intelligent Digital Clinical Medicine, 2026, 1-5.
余燕,钟梦霞,任宴梅.一例艾滋病合并人鼻病毒与马尔尼菲篮状菌共感染的案例分析[J].数智医学, DOI:10.65948/DICM20260701.0002.
余燕, 钟梦霞, 任宴梅. 一例艾滋病合并人鼻病毒与马尔尼菲篮状菌共感染的案例分析[J/OL]. Intelligent Digital Clinical Medicine, 2026, 1-5. DOI: 10.65948/DICM20260701.0002.
患者,男性,42岁,于2025年4月16日因“发热(夜间高热为主)、恶寒、咳嗽咳痰、伴心累乏力、腹胀、食欲减退”就诊于宜宾市第五人民医院。患者入院体温39 ℃,全身皮肤可见多发红色斑疹,存在听诊异常及语言沟通障碍。实验室检查:血液炎症指标(白细胞、中性粒细胞、C-反应蛋白、降钙素原)显著升高;胸部CT提示右肺多发感染性病变;人类免疫缺陷病毒(HIV)抗体检测阳性,基线CD4⁺T淋巴细胞计数仅7个/μL;双侧血液延长培养检出马尔尼菲篮状菌,呼吸道6项病原体核酸检测提示人鼻病毒(HRV)阳性。结合患者病史、症状、体征及辅助检查,明确诊断为艾滋病(AIDS)合并马尔尼菲篮状菌败血症及HRV感染。临床采用富马酸替诺福韦二吡呋酯联合拉米夫定及依非韦伦抗逆转录病毒治疗,同时给予伏立康唑抗真菌、炎琥宁抗病毒对症治疗。经系统治疗后,患者临床症状显著改善,血培养结果转阴,复查胸部CT提示肺部感染病灶较前吸收减少;且出院2周后复查HRV核酸转为阴性,病情恢复良好。
A 42-year-old male patient was admitted to the Fifth People’s Hospital of Yibin on April 16
2025
presenting with fever (predominantly nocturnal high fever)
chills
cough
expectoration
accompanied by palpitation
fatigue
abdominal distension and anorexia. On admission
his body temperature was 39 ℃; multiple erythematous macules were observed all over the skin
with abnormal auscultation findings and impaired verbal co
mmunication. Laboratory examinations revealed markedly elevated inflammatory markers including white blood cell count
neutrophil count
C-reactive protein and procalcitonin. Chest CT showed multiple infectious lesions in the right lung. HIV antibody test was positive
and the baseline CD4⁺T lymphocyte count was only 7 cells/μL. Extended bilateral blood culture yielded Talaromyces marneffei. Nucleic acid testing for six respiratory pathogens confirmed human rhinovirus (HRV) positivity. Based on medical history
clinical manifestations
physical signs and auxiliary examinations
the patient was definitively diagnosed with acquired immunodeficiency syndrome (AIDS) complicated by Talaromyces
marneffei sepsis and human rhinovirus infection. Antiretroviral therapy consisting of tenofovir disoproxil fumarate combined with lamivudine and efavirenz was initiated. Meanwhile
voriconazole was administered for antifungal treatment and Yanhuning for antiviral symptomatic management. After systematic treatment
the patient’s clinical symptoms improved significantly with negative follow-up blood culture results. Repeated chest CT demonstrated absorption and reduction of pulmonary infectious lesions. HRV nucleic acid turned negative at the 2-week follow-up after discharge
indicating favorable recovery.
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张欢 . 120例AIDS患者合并马尔尼菲篮状菌血流感染的回顾性分析 [J ] . 新疆医学 . 2024 , 54 ( 6 ): 670 - 673 .
韦叙 , 陈高 , 盘丽华 , 等 . HIV患者马尔尼菲篮状菌感染的影响因素及预测模型构建 [J ] . 右江民族医学院学报 , 2025 , 47 ( 2 ): 264 - 269,280 .
周游 , 何希 , 黄丽花 , 等 . 多指标单独或联合检测在艾滋病合并马尔尼菲篮状菌感染的诊断价值 [J ] . 中国真菌学杂志 , 2024 , 19 ( 5 ): 480 - 486 .
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