在没有确定的免疫缺陷的患者中传播性组织等离子体病:一个病例报告
Cheng Zeng1, Zhiqiang Jin1, Jiao Liu1
1Department of Infectious Diseases, Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, the Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
概括
散播性基因质菌可能发生在免疫能力强的个体中. 骨髓分析和下一代测序有助于诊断患有源不明发烧的患者,尽管阴性 (1,3) -β-d-葡萄糖测试.
科学领域:
- 传染性疾病 传染性疾病
- 菌类学 菌类学是指菌类学.
- 免疫学 免疫学 免疫学
背景情况:
- 散播性基因质菌症通常在免疫受损的个体中观察到.
- 囊状细胞质是致病剂.
- 该案涉及一名48岁的男性,没有已知的免疫缺陷.
研究的目的:
- 报告在免疫能力较强的宿主中散播性基因质菌病例.
- 突出诊断的挑战和方法.
- 讨论潜在的免疫逃避机制.
主要方法:
- 临床表现:持续发烧,夜间出汗.
- 实验室测试:炎症标志物,肝酶,艾滋病毒,自身抗体,免疫球蛋白,淋巴细胞子集,类风湿因子, (1,3) -β-d-葡萄糖 (BDG),银河体.
- 图像:胸部和腹部CT扫描.
- 诊断确认:骨髓检查,下一代测序 (NGS).
主要成果:
- 患者呈现非特异性全身症状和正常的初始免疫功能.
- 骨髓检查通过NGS揭示了Histoplasma capsulatum,尽管BDG测试呈阴性.
- 治疗反应:最初的波萨康纳是无效的,用安福特素B和德克萨米他改善,然后是伊特拉康纳的维护.
结论:
- 散播性基因质菌可能发生在免疫能力强的个体中.
- 骨髓分析和NGS对于诊断来源不明的发烧非常有价值.
- 负BDG可能是由于真菌细胞壁的组成,有助于免疫逃避.
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