Buchheidt Dieter, Reinwald Mark, Spiess Birgit, Boch Tobias, Hofmann Wolf-Karsten, Groll Andreas H, Lehrnbecher Thomas
Department of Hematology and Oncology, Mannheim University Hospital, University of Heidelberg, Mannheim, Germany.
Infectious Disease Research Program, Center for Bone Marrow Transplantation and Department of Pediatric Hematology and Oncology, University Children's Hospital, Münster, Germany.
Mycoses. 2016 Feb;59(2):67-74. doi: 10.1111/myc.12443. Epub 2015 Dec 14.
Invasive aspergillosis (IA) is an important cause of morbidity and mortality in children and adults with haematologic malignancies or undergoing allogeneic haematopoietic stem cell transplantation, and early diagnosis and adequate antifungal treatment improve outcome. However, important differences exist between children and adults regarding epidemiology, underlying disease, and comorbidities, and the value of diagnostic tools to detect IA may also differ between these patient populations. Imaging studies are important to detect IA early, but typical findings of IA in chest computed tomography of adults are not detected in the majority of children. Whereas the value of the serum marker galactomannan seems to be comparable in children and adults, data on the performance of beta-d-glucan in children are too limited for firm conclusions. PCR-based assays are a promising diagnostic approach to rapidly and reliably detect and identify Aspergillus species in various clinical samples. However, as the majority of data on PCR-based approaches has been obtained in adult patients, the value of this method in paediatric patients has not been defined to date. The present review focuses on studies of PCR-based methods to diagnose IA in immunocompromised paediatric patients.
侵袭性曲霉病（IA）是血液系统恶性肿瘤患儿及成人或接受异基因造血干细胞移植者发病和死亡的重要原因，早期诊断和充分的抗真菌治疗可改善预后。然而，儿童和成人在流行病学、基础疾病及合并症方面存在重要差异，检测IA的诊断工具在这些患者群体中的价值也可能不同。影像学检查对早期发现IA很重要，但大多数儿童胸部计算机断层扫描中IA的典型表现未被发现。虽然血清标志物半乳甘露聚糖在儿童和成人中的价值似乎相当，但关于β -d-葡聚糖在儿童中的表现数据有限，无法得出确切结论。基于聚合酶链反应（PCR）的检测方法是一种有前景的诊断方法，可快速、可靠地检测和鉴定各种临床样本中的曲霉菌种。然而，由于基于PCR方法的大多数数据是在成年患者中获得的，该方法在儿科患者中的价值迄今尚未明确。本综述重点关注基于PCR方法诊断免疫功能低下儿科患者IA的研究。
