Fortún Jesús, Meije Yolanda, Fresco Gema, Moreno Santiago
Servicio de Enfermedades Infecciosas, Hospital Ramón y Cajal, Madrid, Spain.
Enferm Infecc Microbiol Clin. 2012 Apr;30(4):201-8. doi: 10.1016/j.eimc.2011.12.005. Epub 2012 Feb 16.
Invasive aspergillosis, chronic pulmonary aspergillosis and allergic bronchopulmonary aspergillosis are the clinical forms of aspergillosis. Although there is a great number of Aspergillus species, Aspergillus fumigatus-complex is the more frequent aetiological agent, regardless of clinical form or baseline condition. The increase in immunosuppressive agents and the higher use of corticosteroids in chronic obstructive pulmonary disease have led to aspergillosis becoming more prominent in recent years. Galactomannan detection and radiological diagnostic images complement the limitations of microbiology cultures in these patients. Voriconazole and liposomal amphotericin B are the gold standard in patients requiring therapy, and posaconazole, itraconazole, caspofungin and other echinocandins are effective alternatives. The prognosis depends of clinical forms and characteristics of the host, but it is particularly poor in the disseminated invasive forms.
侵袭性曲霉病、慢性肺曲霉病和变应性支气管肺曲霉病是曲霉病的临床类型。尽管曲霉菌种类繁多,但无论临床类型或基线状况如何,烟曲霉复合群都是更常见的病原体。免疫抑制剂使用的增加以及慢性阻塞性肺疾病中皮质类固醇的更多使用导致曲霉病近年来变得更加突出。半乳甘露聚糖检测和放射学诊断图像弥补了这些患者微生物培养的局限性。伏立康唑和脂质体两性霉素B是需要治疗的患者的金标准,泊沙康唑、伊曲康唑、卡泊芬净和其他棘白菌素是有效的替代药物。预后取决于临床类型和宿主特征,但播散性侵袭性类型的预后尤其差。