Chayakulkeeree Methee, Perfect John R
Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, P.O. Box 3353, Durham, NC 27710, USA.
Infect Dis Clin North Am. 2006 Sep;20(3):507-44, v-vi. doi: 10.1016/j.idc.2006.07.001.
In the past 2 decades, Cryptococcus has emerged in its clinical significance and as a model yeast for understanding molecular pathogenesis. C neoformans and C gattii are currently considered major primary and secondary pathogens in a wide array of hosts that are known to be immunocompromised or apparently immunocompetent. A recent outbreak of C gattii infections further underscores the clinical importance of the yeast through its epidemiology and pathogenicity features. With an enlarging immunosuppressed population caused by HIV infection, solid organ transplantation, and clinical use of potent immunosuppressives, such as cancer chemotherapy, monoclonal antibodies, and corticosteroids, this fungus has become a well-established infectious complication of modern medicine. This article examines current issues in cryptococcal infections, including new classification, epidemiology, pathogenesis, and specific clinical aspects.
在过去的20年里,隐球菌在临床意义上已崭露头角,并成为理解分子发病机制的模式酵母。新型隐球菌和格特隐球菌目前被认为是多种宿主中的主要原发性和继发性病原体,这些宿主已知存在免疫功能低下或看似免疫功能正常的情况。最近爆发的格特隐球菌感染通过其流行病学和致病性特征进一步凸显了这种酵母的临床重要性。随着由HIV感染、实体器官移植以及强效免疫抑制剂(如癌症化疗、单克隆抗体和皮质类固醇)的临床使用导致的免疫抑制人群不断扩大,这种真菌已成为现代医学中一种公认的感染性并发症。本文探讨了隐球菌感染的当前问题,包括新的分类、流行病学、发病机制和具体临床方面。