Nataloni S, Gabbanelli V, Rossi R, Donati A, Pantanetti S, Pelaia P
Department of Anaesthesia and Intensive Care Politecnica delle Marche University, Ancona, Italy. Simonetta Nataloni
Minerva Anestesiol. 2007 Jun;73(6):371-5. Epub 2006 Oct 30.
We report two cases of respiratory Aspergillus infection that occurred in patients admitted to the Intensive Care Unit of a teaching hospital during renovation works and treated with new triazole voriconazole (Vfend). The first patient was affected with cerebral hemorrhage, the second with polytrauma and both developed Aspergillus Pneumonia during their ICU stay. Bronchoalveolar lavage, dosage with anti-Aspergillus antibodies, antigen measurements and galactomannan research with Sanofi Platelia were performed. Therapy was carried out with voriconazole for 12 days. Chest X-ray and laboratory tests showed complete resolution after 12 days of therapy; clinical symptoms were negative after 4 days. Aspergillus infection can be observed frequently in non-immunocompromised patients during ward renovation or in hospitals near building areas. Since treatment is often unsuccessful, we preferred to immediately employ new agents to reduce the impact of this disease.
我们报告了两例呼吸曲霉菌感染病例,这两名患者均在一家教学医院的重症监护病房接受治疗,当时该病房正在进行翻新工程,他们接受了新型三唑类药物伏立康唑(威凡)治疗。第一名患者患有脑出血,第二名患者患有多发伤,两人在重症监护病房住院期间均患上了曲霉菌性肺炎。我们进行了支气管肺泡灌洗、抗曲霉菌抗体定量、抗原检测以及使用赛诺菲公司的普立泰利试剂盒进行半乳甘露聚糖检测。使用伏立康唑进行了12天的治疗。治疗12天后胸部X光检查和实验室检查显示完全康复;4天后临床症状消失。在病房翻新期间或建筑物附近的医院中,非免疫功能低下的患者也经常会出现曲霉菌感染。由于常规治疗往往无效,我们更倾向于立即使用新型药物来减轻这种疾病的影响。