Staib F, Bennhold I, Voigt H W, Bangel C, Blisse A
Klin Wochenschr. 1987 Jan 5;65(1):40-7. doi: 10.1007/BF01785527.
Kidney failure and pneumonia by Aspergillus flavus and A. fumigatus were found in a 56-year-old woman who had received antibiotic and corticoid treatment to control high fever. Her bloody tracheal secretion was a suspension of granule-like spore-free colonies of both Aspergillus species. Hemorrhages in mucous membranes and skin suggested a hematogenous dissemination of the fungi. Aspergillus spores in the soil of ornamental plants were assumed to be responsible for the inhalatory infection. The kidney function normalized rapidly under treatment by amphotericin B plus flucytosine and hemodialysis performed eight times. After 29 days of antimycotic treatment (amphotericin B 463 mg, flucytosine 150 g), besides normalization of the kidney function, healing of the pneumonia and bleeding from skin and mucal membranes took place. One and a half years later kidney function and blood parameters were found to be normal. In cases of Aspergillus pneumonia and kidney failure, a combined treatment by hemodialysis and amphotericin B plus flucytosine is recommended. In addition, there is discussion of the general importance of uremia and its influence on the mycotic infection.
一名56岁女性在接受抗生素和皮质类固醇治疗以控制高热后，出现了由黄曲霉和烟曲霉引起的肾衰竭和肺炎。她的血性气管分泌物是两种曲霉菌无孢子颗粒状菌落的悬液。黏膜和皮肤出血提示真菌经血行播散。推测观赏植物土壤中的曲霉菌孢子是吸入性感染的原因。在两性霉素B加氟胞嘧啶治疗及进行了8次血液透析后，肾功能迅速恢复正常。抗真菌治疗29天（两性霉素B 463mg，氟胞嘧啶150g）后，除肾功能恢复正常外，肺炎愈合，皮肤和黏膜出血停止。1年半后，肾功能和血液参数均正常。对于曲霉菌性肺炎和肾衰竭病例，建议采用血液透析联合两性霉素B加氟胞嘧啶治疗。此外，还讨论了尿毒症的总体重要性及其对真菌感染的影响。
