芽生菌病的临床表现与治疗
Clinical Manifestations and Treatment of Blastomycosis.
作者信息
McBride Joseph A, Gauthier Gregory M, Klein Bruce S
机构信息
Division of Infectious Disease, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792, USA; Division of Infectious Disease, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, 1675 Highland Avenue, Madison, WI 53792, USA.
Division of Infectious Disease, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792, USA.
出版信息
Clin Chest Med. 2017 Sep;38(3):435-449. doi: 10.1016/j.ccm.2017.04.006. Epub 2017 Jun 12.
The causal agents of blastomycosis, Blastomyces dermatitidis and Blastomyces gilchristii, belong to a group of thermally dimorphic fungi that can infect healthy and immunocompromised individuals. Following inhalation of mycelial fragments and spores into the lungs, Blastomyces spp convert into pathogenic yeast and evade host immune defenses to cause pneumonia and disseminated disease. The clinical spectrum of pulmonary blastomycosis is diverse. The diagnosis of blastomycosis requires a high degree of clinical suspicion and involves culture-based and non-culture-based fungal diagnostic tests. The site and severity of infection, and the presence of underlying immunosuppression or pregnancy, influence the selection of antifungal therapy.
芽生菌病的病原体皮炎芽生菌和吉尔克里斯特芽生菌属于一群温度双相真菌，可感染健康个体和免疫功能低下者。吸入肺部的菌丝片段和孢子后，芽生菌属转化为致病酵母并逃避宿主免疫防御，从而导致肺炎和播散性疾病。肺芽生菌病的临床谱多样。芽生菌病的诊断需要高度的临床怀疑，涉及基于培养和非培养的真菌诊断测试。感染的部位和严重程度，以及潜在免疫抑制或妊娠的存在，会影响抗真菌治疗的选择。
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