Clinic of Anesthesiology, Ludwig-Maximilians-University, Munich, Germany.
Clinic of Anesthesiology, Ludwig-Maximilians-University, Munich, Germany.
Am J Med Sci. 2012 Feb;343(2):174-176. doi: 10.1097/MAJ.0b013e31823484de.
A 20-year-old man without any history of a pulmonary disease presented initially with a 1-day history of fever and tachypnea and developed an acute respiratory failure within 24 hours. Microbiological and histological examinations raised an invasive pulmonary aspergillosis (IPA). A chronic granulomatous disease was identified as the predisposing factor leading to this severe fungal infection. Chronic granulomatous disease is caused by a reduced ability of phagocytes to mount an oxidative burst due to a defect in the nicotinamide adenine dinucleotide phosphate oxidase. Although IPA occurs usually in severely immunocompromised patients, it should be kept in mind that there are an increasing number of cases developing IPA in the setting of apparent health or to date undiagnosed immunodeficiency that requires further diagnostics.
一位 20 岁的男性，无肺部疾病史，最初表现为发热和呼吸急促 1 天，并在 24 小时内发展为急性呼吸衰竭。微生物学和组织学检查提示侵袭性肺曲霉病（IPA）。慢性肉芽肿病被确定为导致这种严重真菌感染的易患因素。慢性肉芽肿病是由于吞噬细胞产生氧化爆发的能力降低，导致烟酰胺腺嘌呤二核苷酸磷酸氧化酶缺陷所致。虽然 IPA 通常发生在严重免疫功能低下的患者中，但应注意，越来越多的 IPA 病例发生在看似健康或目前未诊断的免疫缺陷患者中，这需要进一步的诊断。
