Department of Medicine, National University Health System, Singapore 119074, Singapore.
Infect Dis Clin North Am. 2010 Sep;24(3):557-77. doi: 10.1016/j.idc.2010.04.003.
Fungal pulmonary infections are becoming more prevalent as a consequence of the rising prevalence of immunocompromised patients. Besides ubiquitous opportunistic fungi such as Aspergillus spp and geographically delimited mycoses, fungi that were previously thought to be of uncertain pathogenicity, such as hyaline and dematiaceous molds, are increasingly being diagnosed as the causes of invasive disease in profoundly immunosuppressed hosts. Overall progress in the clinical management of fungal pulmonary infections has been slow compared with other areas of infectious diseases. However, recent encouraging advances in fungal diagnostics and therapeutics have resulted in improved clinical outcomes, particularly in vulnerable patient populations such as solid organ or allogeneic hematopoietic stem cell transplant recipients. This article provides an overview of endemic mycoses and other emerging fungal pulmonary infections. Recent developments in terms of the diagnosis and clinical management of these infections are also discussed.
真菌性肺部感染的发病率随着免疫功能低下患者的增多而不断升高。除了普遍存在的机会性真菌(如曲霉属真菌)和具有地域局限性的真菌病外,以前被认为致病性不确定的真菌(如透明和暗色真菌),在免疫功能严重低下的宿主中,其作为侵袭性疾病病因的诊断也日益增多。与传染病的其他领域相比,真菌性肺部感染的临床管理总体进展较为缓慢。然而,真菌学诊断和治疗方面的最新进展令人鼓舞,改善了临床结局,尤其是在实体器官或异基因造血干细胞移植受者等易感染人群中。本文对地方性真菌病和其他新发的真菌性肺部感染进行了概述。还讨论了这些感染的诊断和临床管理方面的最新进展。