Marisavljević D, Rolović Z, Bukumirović K, Bosković D, Elezović I
Srp Arh Celok Lek. 1989 Sep-Oct;117(9-10):679-88.
The authors describe 3 patients with confirmed diagnosis of invasive pulmonary aspergillosis (IPA) during the treatment of acute leukaemia in the period July-September 1987. High statistic significance of previous incidence of the disease, high fungal contamination and epidemiologic relationship between cases point at the epidemic. All patients were treated with amphotericin B; two patients died and the third was cured with intensive 6-month--treatment of amphotericin B in the total dose of 4 grams. It is necessery to introduce amphotericin B in therapy of every febrile patient in prolonged granulocytopenia not responsive to 2 combinations of antibiotics after 4 days and persistently looking for radiologic, microbiologic, serologiic and histopathologic evidence of aspergillus infection. In addition to prolonged granulocytopenia high contamination of air with aspergilli is necessery for an epidemic of invasive pulmonary aspergillosis.
作者描述了1987年7月至9月期间在急性白血病治疗过程中确诊为侵袭性肺曲霉病（IPA）的3例患者。该病既往发病率、高真菌污染以及病例之间的流行病学关系具有高度统计学意义，提示存在流行情况。所有患者均接受两性霉素B治疗；2例患者死亡，第3例患者通过6个月的强化两性霉素B治疗（总剂量4克）得以治愈。对于持续粒细胞减少时间较长且对两种抗生素联合治疗4天后无反应的发热患者，有必要在治疗中引入两性霉素B，并持续寻找曲霉感染的放射学、微生物学、血清学和组织病理学证据。除了粒细胞减少时间延长外，空气中曲霉菌的高污染是侵袭性肺曲霉病流行的必要条件。
