The significance of bone marrow smear microscopy in the diagnosis of AIDS complicated with disseminated Penicillium marneffei

doi:10.3969/j.issn.1673-8640.2013.12.008

Abstract

Abstract:

Objective 　To investigate the bone marrow smear microscopy in the diagnosis of acquired immuno-deficiency syndrome (AIDS) complicated with disseminated Penicillium marneffei(PM). Methods　 A total of 257 AIDS patients were enrolled. Bone marrow cell analysis and the peripheral blood and bone marrow fungal dimorphic culture were performed, and the results were analyzed retrospectively. Results　 PM infection was identified in 74 patients by peripheral blood and bone marrow fungal dimorphic culture, and 36 cases were identified as PM infection by bone marrow smear microscopy,among which 3 cases showed negative in fungal dimorphic culture but positive during therapeutic diagnosis. Taking positive fungal dimorphic culture as the standard for PM diagnosis,the specificity of PM by bone marrow smear microscopy was 98.4%, and the sensitivity was 44.6%. The morphology of the bone marrow cell showed that platelet reduced significantly,histiocytosis was reactive, histiocytes were active in phagocytosis,neutrophils developed abnormally or had toxic change,and erythrocytes were morphologically abnormal. The distribution of PM was significantly correlated with the hyperplasia degree of nucleated cell in bone marrow. In the significantly hyperplastic cases,PM were phagocytosed by huge reticulocyte and/or distributed extracellularly. In cases that were hyperplastic,reticulocytes were active in phagocytosis but might not increase,PM could be seen inside or outside of the cells. As for the reduced hyperplastic cases,a small number of PM could be extracellular mainly. The typical characters of PM included sausage shape,elongated cell and a translucent transverse in the middle of the cells before division,and seldom appeared in these cases. Conclusions　 Bone marrow smear microscopy is a highly specific method for the diagnosis of AIDS complicated with disseminated PM. It could facilitate the therapy on time and,sometimes,make up for the omission from the detection of fungal dimorphic culture. It is suitable for the chinical application of AIDS complicated with disseminated PM.

Key words: Penicillium marneffei, Acquired immune deficiency syndrome, Bone marrow smear, Infection

CLC Number:

R446.5

WEI Shanqiu, LUO Xiaolu, LIANG Juanying, FANG Fenghua.. The significance of bone marrow smear microscopy in the diagnosis of AIDS complicated with disseminated Penicillium marneffei[J]. , 2013, 28(12): 1095-1098.

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