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重症监护病房中的侵袭性曲霉病。

Invasive aspergillosis in the intensive care unit.

机构信息

Department of Critical Care Fourth Department of Internal Medicine, University Hospital ATTIKON, Medical School, University of Athens, Greece.

出版信息

Ann N Y Acad Sci. 2012 Dec;1272:31-9. doi: 10.1111/j.1749-6632.2012.06805.x.

Abstract

Invasive aspergillosis is a devastating infection affecting severely immunocompromised patients, most frequently with hematologic malignancies. In recent years, a surge in the incidence of invasive aspergillosis has been reported in critically ill patients without the classical risk factors. The mortality of the disease is equally high in the group of intensive care unit (ICU) patients, while the clinical signs and symptoms are nonspecific and the diagnosis remains a challenge. New noninvasive diagnostic methods in combination with better tolerated antifungal drugs aim for early diagnosis and improved prognosis of invasive aspergillosis. In this review, we discuss the epidemiology, the diagnostic strategy and algorithms, and the therapeutic choices of this severe infection in critically ill patients.

摘要

侵袭性曲霉病是一种严重影响严重免疫功能低下患者的破坏性感染,最常发生于血液恶性肿瘤患者。近年来,重症监护病房(ICU)中无典型危险因素的危重症患者侵袭性曲霉病的发病率急剧上升。该疾病的死亡率在 ICU 患者中同样很高,而临床体征和症状是非特异性的,诊断仍然是一个挑战。新的非侵入性诊断方法结合更好耐受的抗真菌药物旨在实现侵袭性曲霉病的早期诊断和改善预后。在这篇综述中,我们讨论了危重症患者中这种严重感染的流行病学、诊断策略和算法以及治疗选择。

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