■组织胞浆菌病是由荚膜组织胞浆菌引起的深部真菌感染,可归类为肺,传播的或中央的。播散性组织胞浆菌病是所有临床类型中最危险的,其特点是发病迅速,快速发展,高死亡率,诊断和治疗困难。
本报告描述了一名31岁的女性发烧,最高温度为39.8°C。没有伴随症状,比如咳嗽,痰,腹痛和腹泻,在发烧之前,疾病持续了20多天。在检查中,肝脏和脾脏肿大,实验室检测显示CD4细胞数量显著下降,提示免疫缺陷。广谱抗生素治疗无效,和特定的感染性疾病和血液肿瘤被认为是可能的。在接受骨髓抽吸和宏基因组下一代测序(mNGS)后,她最终被诊断出患有播散性组织胞浆菌病,并接受了两性霉素B治疗,氟尿嘧啶和伊曲康唑,有很好的结果。
■该病例表明,播散性组织胞浆菌病感染可伴有无法解释的发热,mNGS可作为诊断该疾病的骨髓穿刺的重要补充。
UNASSIGNED: Histoplasmosis is a deep fungal infection caused by Histoplasma capsulatum and can be classified as pulmonary, disseminated or central. Disseminated histoplasmosis is the most dangerous of all clinical types and is characterized by rapid onset, rapid progression, high mortality, and difficulty in diagnosis and treatment.
UNASSIGNED: This report describes a 31-year-old female who presented with fever, with a maximum temperature of 39.8 °C. There were no concomitant symptoms, such as cough, sputum, abdominal pain and diarrhoea, before the onset of fever, and the illness lasted for more than 20 days. On examination, the liver and spleen were enlarged, and laboratory tests showed a significant decrease in CD4 cell count, suggesting immune deficiency. Broad-spectrum antibiotic treatment was ineffective, and specific infectious diseases and haematological neoplasms were considered likely. She was finally diagnosed with disseminated histoplasmosis after undergoing bone marrow aspiration and metagenomic next-generation sequencing (mNGS) and was treated with amphotericin B, fluorouracil and itraconazole, with good results.
UNASSIGNED: This case demonstrates that disseminated histoplasmosis infection can present with unexplained fever and that mNGS can be an important complement to bone marrow aspiration for the diagnosis of this disease.