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重症监护病房中一名非中性粒细胞减少的危重症患者发生的假膜性曲霉气管支气管炎。

Pseudomembranous aspergillar tracheobronchitis in a non-neutropenic critically ill patient in the intensive care unit.

作者信息

Khalid Sameen, -Rahman Fnu Asad-Ur, Abbass Aamer, Aldarondo Sigfredo, Abusaada Khalid

机构信息

Internal Medicine Department, Florida Hospital, Orlando, FL, USA.

Pulmonary/Critical Care Department, Florida Hospital, Orlando, FL, USA.

出版信息

J Community Hosp Intern Med Perspect. 2017 Mar 31;7(1):43-45. doi: 10.1080/20009666.2017.1287840. eCollection 2017 Jan.

Abstract

Invasive aspergillosis is an important cause of morbidity and mortality among immunocompromised patients. Prolonged neutropenia is the most common risk factor. It has rarely been reported to occur in non-neutropenic critically ill patients in the intensive care unit setting. Mortality rate in this group has been reported to be as high as 92%. We report a case of tracheobronchial aspergillosis in a non-neutropenic critically ill patient to highlight the fact that critically ill patients admitted in the intensive care unit can develop opportunistic infections such as invasive aspergillosis even in the absence of classic risk factors and prior history of immunosuppression. Early diagnosis and prompt initiation of antifungal therapy may improve the outcome and decrease mortality rate.

摘要

侵袭性曲霉病是免疫功能低下患者发病和死亡的重要原因。长期中性粒细胞减少是最常见的危险因素。在重症监护病房环境下,非中性粒细胞减少的重症患者很少发生侵袭性曲霉病。据报道,该组患者的死亡率高达92%。我们报告一例非中性粒细胞减少的重症患者发生气管支气管曲霉病的病例,以强调即使在没有经典危险因素和既往免疫抑制病史的情况下,入住重症监护病房的重症患者也可能发生侵袭性曲霉病等机会性感染。早期诊断并及时开始抗真菌治疗可能改善预后并降低死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/103c/5463668/a568aea2c4da/zjch_a_1287840_f0001_oc.jpg

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