Pergam Steven A
Vaccine & Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, E4-100, Seattle, WA 98109, USA; Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, E4-100, Seattle, WA 98109, USA; Department of Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USA; Infection Prevention, Seattle Cancer Care Alliance, 825 Eastlake Avenue East, Seattle, WA 98109, USA.
Clin Chest Med. 2017 Jun;38(2):279-294. doi: 10.1016/j.ccm.2016.12.006.
Invasive fungal infections, which occur primarily as a consequence of prolonged neutropenia and immunosuppression, are a life-threatening complication seen among patients with hematologic malignancies. The routine use of triazole antifungal prophylaxis, enhanced diagnostics, and newer antifungal agents have led to improvements in the care of fungal pneumonias, but invasive fungal infections remain a major cause of morbidity and mortality. This article covers risk factors for major fungal infections, diagnostic approaches, and treatment options for specific fungal pathogens, including Aspergillus and Mucorales species, and discusses current approved strategies for prevention of common and uncommon fungal pneumonias.
侵袭性真菌感染主要是长期中性粒细胞减少和免疫抑制的结果,是血液系统恶性肿瘤患者中一种危及生命的并发症。三唑类抗真菌预防药物的常规使用、诊断方法的改进以及新型抗真菌药物已使真菌性肺炎的治疗得到改善,但侵袭性真菌感染仍然是发病和死亡的主要原因。本文涵盖主要真菌感染的危险因素、诊断方法以及特定真菌病原体(包括曲霉属和毛霉目菌种)的治疗选择,并讨论了目前已批准的预防常见和罕见真菌性肺炎的策略。