Wightman Sean C, Kim Anthony W, Proia Laurie A, Faber L Penfield, Gattuso Paolo, Warren William H, Liptay Michael J
Division of Thoracic Surgery, Rush University Medical Center, Chicago, Illinois 60612, USA.
Ann Thorac Surg. 2009 Oct;88(4):1352-4. doi: 10.1016/j.athoracsur.2009.02.087.
Fibrosing mediastinitis due to Aspergillus is rare, particularly in the immunocompetent host. Fibrosing mediastinitis due to Aspergillus species in the immunocompetent patient can be indolent and may be treated with antifungal therapy rather than surgery. We present a 78-year-old nonsmoking, nondiabetic woman with chronic fibrosing mediastinitis due to Aspergillus. Multiple attempts at securing a tissue diagnosis were inconclusive. Ultimately, Aspergillus infection was diagnosed by a video-assisted thoracoscopic surgical biopsy. The patient was started on oral voriconazole, and she remains clinically stable with radiographic improvement. A prolonged, perhaps lifelong, course of antifungal therapy is planned.
曲霉菌引起的纵隔纤维化较为罕见，在免疫功能正常的宿主中尤其如此。免疫功能正常的患者由曲霉菌引起的纵隔纤维化可能进展缓慢，可采用抗真菌治疗而非手术治疗。我们报告了一名78岁不吸烟、无糖尿病的女性，患有曲霉菌引起的慢性纵隔纤维化。多次尝试获取组织诊断均未得出明确结论。最终，通过电视辅助胸腔镜手术活检诊断为曲霉菌感染。患者开始口服伏立康唑，目前临床症状稳定，影像学表现有所改善。计划进行长期（可能是终身）的抗真菌治疗。
