Torres A M, Agrawal S, Peters S, Khurana K, Feiglin D, Schroeder E, Izquierdo R
Department of Medicine, Endocrinology, Diabetes and Metabolism, SUNY Health Science Center at Syracuse, New York 13210, USA.
Thyroid. 1999 Nov;9(11):1119-22. doi: 10.1089/thy.1999.9.1119.
Invasive aspergillosis has been increasingly recognized as causing significant morbidity and mortality in immunocompromised patients but has never been diagnosed by fine-needle thyroid aspiration. A 24-year-old female with systemic lupus erythematosus presented with cough, shortness of breath, and fever of unknown origin unresponsive to broad-spectrum antibiotics. History and physical examination failed to indicate a source of infection. An 111In white blood cell scan showed thyroid localization. Physical examination revealed a multinodular goiter with a left dominant nodule. Fine-needle aspiration biopsy of a thyroid nodule revealed branching hyphae suggestive of Aspergillus sp. Despite immediate and aggressive treatment with amphotericin B and fluconazole, the patient died of overwhelming infection.
侵袭性曲霉病在免疫功能低下患者中已越来越被认为是导致严重发病和死亡的原因，但从未通过甲状腺细针穿刺活检诊断出来。一名24岁患有系统性红斑狼疮的女性出现咳嗽、呼吸急促和不明原因发热，对广谱抗生素无反应。病史和体格检查未能发现感染源。铟-111白细胞扫描显示甲状腺部位有定位。体格检查发现有一个多结节性甲状腺肿，以左侧优势结节为主。甲状腺结节的细针穿刺活检显示有分支菌丝，提示为曲霉菌属。尽管立即使用两性霉素B和氟康唑进行积极治疗，但患者死于严重感染。
