Department of Medicine, Division of Infectious Diseases, Virginia Commonwealth University, VMI Building, Suite 205, 1000 East Marshall Street, Richmond, VA 23298, USA.
Department of Medicine, Division of Infectious Diseases, University of Pittsburgh, 3601 Fifth Avenue, Suite 3A, Pittsburgh, PA 15213, USA.
Clin Chest Med. 2017 Dec;38(4):727-739. doi: 10.1016/j.ccm.2017.07.013. Epub 2017 Sep 28.
Respiratory fungal infections are associated with high morbidity and mortality in hematopoietic stem cell (HSCT) and solid organ (SOT) transplant recipients, and are caused primarily by molds. Aspergillus is the most common pathogen. The net state of immunosuppression plays a major role in the risk of respiratory fungal infections after transplantation. Clinical presentation can be atypical and diagnosis can be delayed due to low sensitivity of diagnostic methods or inability to obtain adequate specimens. Fungal infections in HSCT and SOT carry a higher risk of dissemination. New prophylaxis strategies have changed the epidemiology of fungal infections in this patient population.
造血干细胞(HSCT)和实体器官(SOT)移植受者的肺部真菌感染与高发病率和高死亡率相关,且主要由霉菌引起。曲霉菌是最常见的病原体。移植后发生肺部真菌感染的风险主要与免疫抑制状态的净效应有关。临床表现可能不典型,且由于诊断方法的敏感性低或无法获取足够的标本,诊断可能会延迟。HSCT 和 SOT 中的真菌感染有更高的播散风险。新的预防策略改变了此类患者人群中真菌感染的流行病学。