需要辅助性皮质类固醇治疗的慢性播散性念珠菌病患者的临床特征及预后
Clinical characteristics and outcomes of patients with chronic disseminated candidiasis who need adjuvant corticosteroid therapy.
作者信息
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
机构信息
Department of Infectious Diseases.
Division of Infectious Disease, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.
出版信息
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。
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