Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida.
Department of Internal Medicine, University of Miami Miller School of Medicine, Miami, Florida.
Mycoses. 2019 Sep;62(9):826-834. doi: 10.1111/myc.12928. Epub 2019 May 31.
Febrile neutropaenia (FNP) is a common cause of morbidity and mortality in immunocompromised patients. Although most infections are caused by bacterial pathogens, fungal infections are becoming increasingly more common. Due to its rarity, the diagnosis of fungal infections in febrile neutropenic patients is often delayed. To provide current clinical features, epidemiology, aetiology, diagnosis and treatment of cutaneous involvement of fungal infection in patients with FNP. A retrospective literature review of PubMed was performed, with no language or publishing data restrictions, yielding 116 results. We queried each case for cutaneous lesions associated with fungal pathogens in FNP. We found 54 publications with 215 reported cases of cutaneous manifestations of fungal injury in patients with FNP. This study is limited in that it is a literature review of a disease that is likely underreported. Cutaneous lesions caused by yeasts such as Candida and Trichosporon manifest as diffuse erythematous papules and usually do not develop central necrosis or eschar, while moulds will present as tender nodules that subsequently develop eschar and necrosis. Recognising the cutaneous manifestations of fungal disease can assist in the diagnosis and management of these infections.
发热性中性粒细胞减少症（FN）是免疫功能低下患者发病和死亡的常见原因。尽管大多数感染是由细菌病原体引起的，但真菌感染越来越常见。由于其罕见性，FN 患者真菌感染的诊断常常被延误。本文旨在为 FN 患者的真菌感染提供当前的临床特征、流行病学、病因、诊断和治疗方法。我们对 PubMed 进行了回顾性文献检索，没有语言或出版数据限制，共得到 116 项结果。我们对每个病例进行了检索，以确定与 FN 中真菌病原体相关的皮肤损伤。我们发现 54 篇文献中有 215 例 FN 患者的皮肤真菌损伤表现。本研究的局限性在于，它是对一种可能报告不足的疾病的文献回顾。酵母菌（如 Candida 和 Trichosporon）引起的皮肤损伤表现为弥漫性红斑丘疹，通常不会发生中央坏死或焦痂，而霉菌会表现为触痛性结节，随后形成焦痂和坏死。认识到真菌病的皮肤表现有助于这些感染的诊断和治疗。
