Nagasawa M, Itoh S, Tomizawa D, Kajiwara M, Sugimoto T, Kumagai J
Department of Pediatrics, Tokyo, Japan.
J Infect. 2002 Apr;44(3):198-201. doi: 10.1053/jinf.2001.0935.
A 19-year-old female with aplastic anemia who developed subglottal aspergillosis is reported. She presented with fever, cough and stridor. Inspiratory dyspnea progressed rapidly and emergent tracheostomy was performed, which confirmed the diagnosis. In spite of intensive anti-fungal treatment combined with adoptive immunotherapy, Aspergillus infection expanded and she died of pulmonary aspergillosis. Autopsy revealed the fungal mass obstructing the trachea and disseminated pulmonary aspergillosis. Difficulties in diagnosis and management of subglottal Aspergillus infection are discussed.
报道了一名19岁再生障碍性贫血女性患者，其发生了声门下曲霉菌病。她出现发热、咳嗽和喘鸣。吸气性呼吸困难迅速进展，遂紧急行气管切开术，这证实了诊断。尽管进行了强化抗真菌治疗并联合过继性免疫疗法，但曲霉菌感染仍蔓延，她最终死于肺曲霉菌病。尸检发现真菌团块阻塞气管及播散性肺曲霉菌病。文中讨论了声门下曲霉菌感染的诊断和管理难点。
