Le Bourgeois M, Sermet I, Bailly-Botuha C, Delacourt C, de Blic J
Service de Pneumologie et Allergologie Pédiatriques, Hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France.
Arch Pediatr. 2011 May;18 Suppl 1:S15-21. doi: 10.1016/S0929-693X(11)70936-8.
Fungal colonization in cystic fibrosis patient is frequent and dominated by Aspergillus fumigatus (A. fumigatus). Mycological analysis on specific media showed other filamentous species Scedosporium, Geosmithia argillacea. Prospective studies are necessary to appreciate prevalence and pathogenicity in this pathology. A. fumigatus causes the most frequently allergic bronchopulmonary aspergillosis (ABPA). Invasive infection is exceptional in this context. An early diagnosis is important to avoid bronchial deterioration but is very difficult despite international consensus. New more specific biological markers are evaluated. Oral corticotherapy is the cornerstone of therapy but adverse effects are more frequent in cystic fibrosis. Antifungal therapy has a corticosteroid-sparing effect. New therapeutic strategies have to be evaluated.
囊性纤维化患者的真菌定植很常见，且以烟曲霉为主。在特定培养基上进行的真菌学分析显示还存在其他丝状菌，如波氏假霉样真菌、黏土嗜热放线菌。有必要进行前瞻性研究以了解这种病理状况下的患病率和致病性。烟曲霉最常引起变应性支气管肺曲霉病（ABPA）。在这种情况下，侵袭性感染很罕见。早期诊断对于避免支气管恶化很重要，但尽管有国际共识，诊断仍非常困难。正在评估更新的特异性生物标志物。口服皮质激素疗法是治疗的基石，但在囊性纤维化患者中不良反应更常见。抗真菌治疗具有节省皮质类固醇的作用。必须评估新的治疗策略。
