Yamamoto Tetsushi, Kasagi Shimpei, Kurimoto Chiyo, Imanishi Takamitsu, Hayashi Nobuhide, Morinobu Akio, Saegusa Jun
Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan.
Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Kobe, Japan.
J Clin Ultrasound. 2018 Mar;46(3):231-232. doi: 10.1002/jcu.22501. Epub 2017 Jun 1.
A 38-year-old woman was diagnosed with systemic lupus erythematosus and received immunosuppressive therapy. After 6 months of treatment, workup for low-grade fever yielded elevated enzyme-linked immunosorbent assay titers for Aspergillus antigen in serum and ascites, leading to the diagnosis of disseminated aspergillosis. Transthoracic echocardiography revealed a claviform vegetation attached to the left ventricular anterior septum. Two days after the start of antifungal Amphotericin-B therapy, the patient suffered from several neurologic disorders. A second transthoracic echocardiography revealed that the vegetation decreased in size. Two weeks later, the vegetation increased again. Combination therapy of Amphotericin-B and Voriconazole was initiated, and the vegetation eventually disappeared completely. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 46:231-232, 2018.
一名38岁女性被诊断为系统性红斑狼疮并接受免疫抑制治疗。治疗6个月后，针对低热进行检查发现血清和腹水中曲霉抗原的酶联免疫吸附测定滴度升高，从而诊断为播散性曲霉病。经胸超声心动图显示左心室前间隔有一个棒状赘生物。抗真菌两性霉素B治疗开始两天后，患者出现多种神经功能障碍。第二次经胸超声心动图显示赘生物尺寸减小。两周后，赘生物再次增大。开始两性霉素B和伏立康唑联合治疗，赘生物最终完全消失。© 2017威利期刊公司。《临床超声杂志》46:231 - 232，2018年。
