Tschechne B, Brunkhorst U, Ruhnke M, Trautmann M, Dempe S, Deicher H
Abteilung Immunologie und Transfusionsmedizin, Zentrum Innere Medizin, Medizinische Hochschule, Hannover.
Med Klin (Munich). 1991 Oct 15;86(10):508-11.
50 HIV-positive patients (CDC stage III to VI) with oral candidiasis proven by culture and typical clinical findings were treated with fluconazole (50 to 100 mg/day) over a period of eight to 22 days. After completion of treatment, clinical signs of oral candidiasis had disappeared in 45/50 patients. In 10/50 patients, however, increased concentrations of candida both in pharyngeal washes (greater than 10(2) PFU/ml) and throat swabs (greater than 20 colonies/culture) persisted. Four weeks later, clinical candidiasis had reappeared in 22/42 patients and another 14/42 patients without clinical symptoms had pathological concentrations of candida in culture. In no case did treatment with fluconazole itself have to be aborted because of adverse reactions. Most of the patients had multiple concomitant bacterial and/or viral infections requiring comprehensive medication. The side effects observed (nausea, headache, changes in the blood picture, etc.) were due to the concomitant infections and their specific therapy.
50例经培养及典型临床症状确诊为口腔念珠菌病的HIV阳性患者（美国疾病控制与预防中心III至VI期），接受氟康唑治疗（50至100毫克/天），疗程为8至22天。治疗结束后，45/50例患者口腔念珠菌病的临床症状消失。然而，10/50例患者咽部冲洗液（大于10²PFU/ml）和咽拭子（大于20个菌落/培养物）中的念珠菌浓度持续升高。四周后，22/42例患者临床念珠菌病复发，另外14/42例无临床症状的患者培养物中念珠菌浓度呈病理性升高。在任何情况下，氟康唑治疗本身均未因不良反应而中断。大多数患者同时患有多种细菌和/或病毒感染，需要综合用药。观察到的副作用（恶心、头痛、血象变化等）是由合并感染及其特异性治疗引起的。
