Department of Dermatology and Mycology Center, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, 200003, Shanghai, China.
Mycopathologia. 2010 Aug;170(2):117-21. doi: 10.1007/s11046-010-9300-y. Epub 2010 Mar 24.
We reported a case of aspergillosis presented as cholangitis in a patient after liver transplantation, even with prophylactic use of fluconazole. The patient had multiple predisposing factors, such as leukocytopenia, immunosuppressive drug therapy. He died 2 days after an exploratory laparotomy was carried out. The histopathologic finding of biopsy specimen from biliary tract was positive for Aspergillus. And the pathogen was identified as Aspergillus flavus by mycological culture and PCR. The patient was confirmed as a case of Aspergillosis of biliary tract that was responded poorly to fluconazole. This indicated that azole should have been switched to more effective antifungal agents at earlier stage when the patients responded poorly to the original treatment.
我们报告了一例肝移植后曲霉菌病表现为胆管炎的病例，即使使用了氟康唑预防。患者有多种易感因素，如白细胞减少症、免疫抑制药物治疗。在进行剖腹探查术后 2 天，患者死亡。胆道活检组织的组织病理学检查结果为曲霉菌阳性。通过真菌培养和 PCR 鉴定病原体为黄曲霉菌。该患者被确诊为胆道曲霉病，对氟康唑反应不佳。这表明当患者对初始治疗反应不佳时，应尽早将唑类药物更换为更有效的抗真菌药物。
