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第七章:接合菌病。

Chapter 7: zygomycosis.

机构信息

Postgraduate Program in Pulmonology, Federal University of Rio Grande do Sul - Porto Alegre, Brazi.

出版信息

J Bras Pneumol. 2010 Jan-Feb;36(1):134-41. doi: 10.1590/s1806-37132010000100018.

Abstract

Zygomycosis (mucormycosis) is a rare but highly invasive infection caused by fungi belonging to the order Mucorales, which includes the genera Rhizopus, Mucor, Rhizomucor, Absidia, Apophysomyces, Saksenaea, Cunninghamella, Cokeromyces and Syncephalastrum. This type of infection is usually associated with hematologic diseases, diabetic ketoacidosis and organ transplantation. The most common form of presentation is rhinocerebral mucormycosis, with or without pulmonary involvement. Pulmonary zygomycosis is more common in patients with profound, prolonged neutropenia and can present as segmental or lobar infiltrates, isolated nodules, cavitary lesions, hemorrhage or infarction. The clinical and radiological manifestations are often indistinguishable from those associated with invasive aspergillosis. This article describes the general characteristics of pulmonary zygomycosis, emphasizing laboratory diagnosis, and illustrates the morphology of some lesions.

摘要

接合菌病(毛霉病)是一种罕见但具有高度侵袭性的感染,由属于毛霉目(Mucorales)的真菌引起,该目包括根毛霉属(Rhizopus)、毛霉属(Mucor)、根毛霉属(Rhizomucor)、伞毛霉属(Absidia)、波氏假丝酵母属(Apophysomyces)、萨氏毛霉属(Saksenaea)、卷枝毛霉属(Cunninghamella)、毛壳菌属(Cokeromyces)和盾壳霉属(Syncephalastrum)。这种感染通常与血液疾病、糖尿病酮症酸中毒和器官移植有关。最常见的表现形式是鼻脑毛霉病,伴有或不伴有肺部受累。肺部接合菌病在深度和长时间中性粒细胞减少症的患者中更为常见,可表现为节段性或肺叶浸润、孤立性结节、空洞性病变、出血或梗死。临床和影像学表现常与侵袭性曲霉菌病难以区分。本文描述了肺部接合菌病的一般特征,强调了实验室诊断,并说明了一些病变的形态学特征。

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