Girmenia C, Nucci M, Martino P
Dipartimento di Biotecnologie Cellulari ed Ematologia, University La Sapienza, Rome, Italy.
Br J Haematol. 2001 Jul;114(1):93-8. doi: 10.1046/j.1365-2141.2001.02901.x.
The clinical significance of Aspergillus fungaemia in the setting of a deep-seated aspergillosis has not been clearly established. Among 107 microbiologically documented Aspergillus infections in patients with haematological diseases observed over a 17-year period, blood cultures grew Aspergillus species from 10 cases. Aspergillus fungaemia was documented in 9 out of 89 (10.1%) patients with pulmonary aspergillosis at a median of 5 d from the onset of clinical signs of infection, and in one patient with central venous catheter focal infection. Five (50%) patients died as a result of fungal infection a median of 12 d (range 4--48) from the documentation of Aspergillus fungaemia. A comparison between cases of invasive aspergillosis with or without fungaemia showed that fungaemic patients were similar to those without positive blood cultures regarding clinical presentation, risk factors, clinical course and outcome. The diagnostic role of Aspergillus fungaemia in the setting of a deep-seated infection is limited because blood cultures become positive when a microbiological or clinical diagnosis of aspergillosis has already been performed. Aspergillus fungaemia does not necessarily seem to be correlated with a disseminated infection or a poorer prognosis.
在深部曲霉菌病背景下,曲霉菌性菌血症的临床意义尚未明确确立。在17年期间观察到的107例血液学疾病患者中,经微生物学证实的曲霉菌感染病例里,有10例血培养长出曲霉菌。89例肺曲霉菌病患者中有9例(10.1%)被记录为曲霉菌性菌血症,从感染临床症状出现起中位时间为5天,还有1例中心静脉导管局部感染患者。5例(50%)患者因真菌感染死亡,从曲霉菌性菌血症记录起中位时间为12天(范围4 - 48天)。对有或无菌血症的侵袭性曲霉菌病病例进行比较发现,菌血症患者在临床表现、危险因素、临床病程和结局方面与血培养未阳性的患者相似。在深部感染背景下,曲霉菌性菌血症的诊断作用有限,因为当已经做出曲霉菌病的微生物学或临床诊断时血培养才呈阳性。曲霉菌性菌血症不一定似乎与播散性感染或更差的预后相关。