Arif Sana, Perfect John R
Division of Infectious Diseases, Duke University Medical Center, 315 Trent Drive, PO Box 102359, Durham, NC 27710, USA.
Division of Infectious Diseases, Duke University Medical Center, 315 Trent Drive, PO Box 102359, Durham, NC 27710, USA.
Clin Chest Med. 2017 Sep;38(3):555-573. doi: 10.1016/j.ccm.2017.04.014. Epub 2017 Jun 2.
Immunocompromised patients are at high risk for invasive fungal infections (IFIs); although Aspergillus remains the most common IFI caused by molds, other fungi, such as Mucorales, dematiaceous molds, and Fusarium spp, are being seen with increasing frequency. Presentations can vary, but sinopulmonary and disseminated infections are common. Our understanding of the pathogenesis of these infections is rudimentary. Fungal cultures and histopathology remain the backbone of diagnostics, as no good serologic markers are available. Polymerase chain reaction tests are being developed but currently remain investigational. Management of these infections is usually multidisciplinary, requiring surgical debridement along with antifungal therapy.
免疫功能低下的患者发生侵袭性真菌感染（IFI）的风险很高；尽管曲霉菌仍然是由霉菌引起的最常见的IFI，但其他真菌，如毛霉目真菌、暗色霉菌和镰刀菌属，出现的频率也在增加。临床表现可能各不相同，但鼻窦肺部感染和播散性感染很常见。我们对这些感染发病机制的了解还很初步。真菌培养和组织病理学仍然是诊断的基础，因为目前还没有很好的血清学标志物。聚合酶链反应检测正在研发中，但目前仍处于研究阶段。这些感染的治疗通常需要多学科协作，需要手术清创并联合抗真菌治疗。
