Jang Young-Rock, Kim Min-Chul, Kim Taeeun, Chong Yong Pil, Lee Sang-Oh, Choi Sang-Ho, Kim Yang Soo, Woo Jun Hee, Hong Jung Yong, Yoon Dok Hyun, Suh Cheolwon, Lee Jung-Hee, Lee Je-Hwan, Lee Kyoo-Hyung, Kim Sung-Han
Department of Infectious Diseases.
Division of Infectious Disease, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.
Med Mycol. 2018 Aug 1;56(6):782-786. doi: 10.1093/mmy/myx110.
We performed a retrospective study involving 21 patients with chronic disseminate candidiasis (CDC) and 38 patients with candidemia. Neutropenia of >2 weeks' duration was more common in those with CDC (71%) than in those with candidemia (26%, P < .001), and the azole-resistant rate in patients with CDC (5%) was lower than that in those with candidemia (29%, P = .03). Of the 21 patients with CDC, five (24%) needed adjuvant corticosteroid therapy due to persistent debilitating fever (median, 19 days). Rapid defervescence (median, 5 days) occurred after adjuvant corticosteroid therapy. However, there were no significant differences in 90-day mortality between CDC patients with and without corticosteroid therapy. Further prospective data are needed to define the role of steroids in this setting.
我们进行了一项回顾性研究,纳入了21例慢性播散性念珠菌病(CDC)患者和38例念珠菌血症患者。持续时间超过2周的中性粒细胞减少症在CDC患者中(71%)比在念珠菌血症患者中(26%,P <.001)更常见,CDC患者的唑类耐药率(5%)低于念珠菌血症患者(29%,P =.03)。在21例CDC患者中,5例(24%)因持续虚弱性发热(中位时间为19天)需要辅助性皮质类固醇治疗。辅助性皮质类固醇治疗后出现快速退热(中位时间为5天)。然而,接受和未接受皮质类固醇治疗的CDC患者在90天死亡率方面没有显著差异。需要进一步的前瞻性数据来确定类固醇在这种情况下的作用。