Matsui Yuichi, Sugawara Yasuhiko, Tsukada Kunihisa, Kishi Yoji, Shibahara Junji, Makuuchi Masatoshi
Department of Surgery, Artificial Organ and Transplantation Division, Graduate School of Medicine, University of Tokyo, Tokyo 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
J Infect. 2006 Dec;53(6):e231-3. doi: 10.1016/j.jinf.2006.02.007. Epub 2006 Mar 29.
Aspergillosis is increasingly recognized as an important nosocomial pathogen in immunocompromised patients. Infection is difficult to diagnose and typically has a fatal outcome. We describe a liver transplant patient with fulminant hepatic failure, who had persistent fever of undetected origin postoperatively and an increased (1-3)-beta-d glucan level. Gallium-67 citrate scanning showed abnormal uptake in the thyroid bilaterally. Fine needle biopsy of the thyroid revealed thyroidal invasion of Aspergillosis. Total thyroidectomy was performed and the C reactive protein level decreased to 1.01 mg/dl. The patient died of liver sepsis due to Pseudomonas aeruginosa. (1-3)-beta-d Glucan monitoring and systematic radionuclide images are useful modalities for early diagnosis of Aspergillosis.
曲霉病日益被认为是免疫功能低下患者重要的医院感染病原体。感染难以诊断，通常会导致致命后果。我们描述了一名肝移植患者，该患者术后出现暴发性肝衰竭，持续发热且病因不明，同时（1-3）-β-d葡聚糖水平升高。枸橼酸镓-67扫描显示双侧甲状腺摄取异常。甲状腺细针穿刺活检显示甲状腺受曲霉病侵犯。患者接受了甲状腺全切术，C反应蛋白水平降至1.01mg/dl。患者死于铜绿假单胞菌引起的肝败血症。（1-3）-β-d葡聚糖监测和系统性放射性核素成像对于曲霉病的早期诊断是有用的方法。
