无明显侵袭性曲霉病危险因素患者的严重发热伴血小板减少综合征合并假膜性曲霉气管支气管炎

Sakaguchi Kento, Koga Yasutaka, Yagi Takeshi, Nakahara Takashi, Todani Masaki, Fujita Motoki, Tsuruta Ryosuke

Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, Japan.

Department of Emergency and Critical Care Medicine, Yamagata University Faculty of Medicine, Japan.

Intern Med. 2019 Dec 15;58(24):3589-3592. doi: 10.2169/internalmedicine.3257-19. Epub 2019 Jul 31.

Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne infectious disease. A 91-year-old woman was admitted to our intensive-care unit with SFTS, and she developed dyspnea with wheezes 5 days after admission. Bronchoscopy showed scattered white mold in her central airway. An airway tissue biopsy and culture of bronchial lavage fluid revealed fungal hyphae in the necrotic tissue, confirmed as Aspergillus fumigatus. She was thus diagnosed with pseudomembranous aspergillus tracheobronchitis. She had no common risk factors for invasive aspergillosis (IA). Patients with SFTS, even those without apparent risk factors for IA, may be at risk of developing IA.

发热伴血小板减少综合征（SFTS）是一种蜱传感染性疾病。一名91岁女性因SFTS入住我们的重症监护病房，入院5天后出现呼吸困难并伴有喘息声。支气管镜检查显示其中心气道有散在白色霉菌。气道组织活检及支气管灌洗液培养在坏死组织中发现真菌菌丝，确诊为烟曲霉。因此，她被诊断为假膜性曲霉气管支气管炎。她没有侵袭性曲霉病（IA）的常见危险因素。SFTS患者，即使是那些没有明显IA危险因素的患者，也可能有发生IA的风险。