伏立康唑成功治疗慢性侵袭性曲霉菌性鼻窦炎和中耳炎伴脑膜播散
Chronic Invasive Aspergillus Sinusitis and Otitis with Meningeal Extension Successfully Treated with Voriconazole.
作者信息
Morgand Marjolaine, Rammaert Blandine, Poirée Sylvain, Bougnoux Marie-Elisabeth, Tran Hugo, Kania Romain, Chrétien Fabrice, Jouvion Gregory, Lortholary Olivier
机构信息
Université Paris Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, Service des Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, Institut Imagine, AP-HP, Paris, France.
Université Paris Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, Service de Radiologie Adulte, AP-HP, Paris, France.
出版信息
Antimicrob Agents Chemother. 2015 Dec;59(12):7857-61. doi: 10.1128/AAC.01506-15. Epub 2015 Sep 21.
Invasive aspergillosis (IA) is a severe disseminated fungal disease that occurs mostly in immunocompromised patients. However, central nervous system IA, combining meningitis and skull base involvement, does not occur only in groups with classic risk factors for IA; patients with chronic renal failure and diabetes mellitus are also at risk for more chronic forms. In both of our proven IA cases, voriconazole monotherapy was effective without surgery, and cerebrospinal fluid and serum 1,3-β-d-glucan test results were initially positive, in contrast to galactomannan antigen results.
侵袭性曲霉病（IA）是一种严重的播散性真菌病，主要发生在免疫功能低下的患者中。然而，合并脑膜炎和颅底受累的中枢神经系统IA并非仅发生在具有IA典型危险因素的人群中；慢性肾功能衰竭和糖尿病患者也有发生更慢性形式的风险。在我们确诊的两例IA病例中，伏立康唑单药治疗无需手术即有效，与半乳甘露聚糖抗原结果相反，脑脊液和血清1,3-β-d-葡聚糖检测结果最初呈阳性。
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