Ng P C, Lee C H, Fok T F, Chui K, Wong W, Cheung K L, So K W
Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories.
J Paediatr Child Health. 2000 Oct;36(5):509-10. doi: 10.1046/j.1440-1754.2000.00520.x.
Two rare cases of isolated central nervous system (CNS) candidiasis in preterm infants have been diagnosed in a tertiary neonatal centre over the past 6 years. Despite the life-threatening nature of the disease, biochemical infection markers were not useful for the early identification of localized fungal infection. Because the infection was likely to have been blood borne, we postulated that the initial fungal load was probably low and that the organisms were rapidly eliminated from the circulation after a few had been deposited in the CNS. Hence, the absence of fungaemia or systemic involvement precluded the activation of cytokines and cellular markers. Clinicians should be aware of the limitation of biochemical infection markers so that diagnosis and treatment of fungal infection will not be delayed.
在过去6年里，一家三级新生儿中心诊断出两例早产儿孤立性中枢神经系统（CNS）念珠菌病的罕见病例。尽管该疾病具有危及生命的性质，但生化感染标志物对早期识别局部真菌感染并无帮助。由于感染可能是血行传播的，我们推测最初的真菌负荷可能较低，并且在少数真菌沉积于中枢神经系统后，这些微生物很快就从循环中被清除了。因此，没有真菌血症或全身受累就无法激活细胞因子和细胞标志物。临床医生应意识到生化感染标志物的局限性，以免延误真菌感染的诊断和治疗。
