摘要
目的了解肺假丝酵母菌病的临床特点。方法分析2012年5月—2013年5月解放军白求恩国际和平医院确诊和临床诊断的肺假丝酵母菌病7例的临床资料。结果 7例均患有严重的基础疾病,主要症状为发热、咳嗽、咳痰等,影像学检查示:肺部可见片状、斑片状高密度影6例,肺纹理增粗1例,双下肺结节影1例;B超检查示胸腔积液2例。社区获得性肺假丝酵母菌病2例,医院获得性肺假丝酵母菌病5例。1例肺活检组织和痰液培养检出白假丝酵母菌而确诊,4例血液和痰液培养检出假丝酵母菌、1例胸腔积液和痰液均检出白假丝酵母菌、1例单纯胸腔积液检出白假丝酵母菌而临床诊断。本组确诊前均予抗细菌治疗,确诊后4例予抗真菌治疗,1例治愈,1例症状好转,2例死亡;另3例未予抗真菌治疗,2例死亡,1例主动出院、放弃治疗。结论肺假丝酵母菌病预后差、病死率高,采用多种实验室检查方法并结合影像学检查可提高肺假丝酵母菌病的诊断水平。
Objective To study the clinical characteristics of pulmonary candidiasis. Methods Clinical data of 7 patients with pulmonary candidiasis during May 2012 and May 2013 who were confirmed or clinical diagnosis as having pulmonary candidiasis was analyzed. Results Seven patients had severe basic diseases, and the main symptoms were fe- ver, cough and expectoration. Iconography examination showed 6 cases of lamellar or patching of high density in lung, thickening lung markings in 1 case and 1 case of bilateral lower pulmonary nodules; type-B ultrasound examination showed 2 cases of pleural effusion. There were 2 cases of community-acquired pulmonary candidiasis and 5 cases of hospi- tal-acquired pulmonary candidiasis. One case confirmed of the diagnosis by Candida albicans was detected from the lung biopsy and sputum cultivation; 4 cases were diagnosed by blood and sputum culture, 1 case by Candida albicans was de- tected from pleural effusion and sputum samples, and 1 case by Candida albicans was detected from pleural effusion. All the cases were treated with anti-bacteria treatment before confirmed diagnosis. After the diagnosis, 4 cases were treated with antifungal therapy. Of the 4 patients, 1 patient was cured, 1 was improved, and 2 died; 3 other patients were not treated with antifungal therapy, then 2 patients died, and 1 required dismission and gave up the therapy. Conclusion Pulmonary candidiasis is a disease of poor prognosis with a high mortality rate, and the diagnosis level can be improved by using many kinds of laboratory examinations combined with iconography results.
出处
《解放军医药杂志》
CAS
2014年第2期81-84,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
河北省自然科学基金项目(C2010001882)
关键词
念珠菌病
肺
念珠菌属
诊断技术与方法
活组织检查
针吸
血液
胸腔积液
痰
Candidiasis, pulmonary
Candida
Diagnostic technique and procedure
Biopsy, needle
Blood
Pleural effusion
Sputum
