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原发性胃肠道曲霉病:一例报告及文献综述

Primary gastrointestinal aspergillosis: a case report and literature review.

作者信息

Ceylan Bahadir, Yilmaz Mesut, Beköz Hüseyin Saffet, Ramadan Saime, Ertan Akan Gülhan, Mert Ali

机构信息

Medipol University, Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey.

Medipol University, Faculty of Medicine, Department of Hematology, Istanbul, Turkey.

出版信息

Infez Med. 2019 Mar 1;27(1):85-92.

Abstract

Invasive aspergillosis is a severe infection that generally involves the lungs. Primary gastrointestinal aspergillosis is the least common form of invasive aspergillosis. A patient aged 65 years developed a febrile neutropenic episode following an autologous stem cell transplant for plasmacytoid variant diffuse large B-cell gastric non-Hodgkin's lymphoma. He had abdominal pain on the second day of the febrile neutropenic episode and ileus occurred on the sixth day. His general condition deteriorated despite broad spectrum antibiotics and caspofungin treatment, and intestinal perforation occurred on the nineteenth day of the febrile neutropenic episode. Pathological examination of the resected jejunum and ileum revealed mould hyphae compatible with aspergillus. The patient died due to massive gastrointestinal bleeding on the fifth post-operative day. Although a rare condition, primary gastrointestinal aspergillosis should be kept in mind while treating neutropenic patients with gastrointestinal symptoms.

摘要

侵袭性曲霉病是一种严重感染,通常累及肺部。原发性胃肠道曲霉病是侵袭性曲霉病最不常见的形式。一名65岁患者因浆细胞样变异型弥漫性大B细胞胃非霍奇金淋巴瘤接受自体干细胞移植后出现发热性中性粒细胞减少症。发热性中性粒细胞减少症发作第二天他出现腹痛,第六天发生肠梗阻。尽管使用了广谱抗生素和卡泊芬净治疗,其一般状况仍恶化,发热性中性粒细胞减少症发作第19天发生肠穿孔。切除的空肠和回肠病理检查显示与曲霉相符的霉菌菌丝。患者术后第五天因大量胃肠道出血死亡。虽然原发性胃肠道曲霉病是一种罕见病症,但在治疗有胃肠道症状的中性粒细胞减少患者时应予以考虑。

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