Johnson J A, Pearson J C, Kubiak D W, Dionne B, Little S E, Wesemann D R
Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Department of Pharmacy, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Open Forum Infect Dis. 2020 Sep 26;7(10):ofaa447. doi: 10.1093/ofid/ofaa447. eCollection 2020 Oct.
Chronic granulomatous disease (CGD) is a primary immunodeficiency syndrome that results in increased risk for bacterial and fungal infections, as well as inflammatory/autoimmune complications. While CGD historically has been associated with early death in childhood, the life expectancy and morbidity of patients with CGD have greatly improved. Many patients with CGD now survive well into adulthood, and data on adult cohorts of patients with CGD have been published. However, reports of pregnancy management, complications, and outcomes for patients with CGD are sparse. In addition, management of invasive fungal infections, including use of newer triazole antifungals, during pregnancy has not been well described. We report a case of fungal lung infection in a pregnant woman with CGD, diagnosed during her second trimester, which was treated with multiple antifungal agents, including more than 12 weeks of isavuconazole therapy, resulting in resolution of infection and delivery of a healthy newborn at term.
慢性肉芽肿病（CGD）是一种原发性免疫缺陷综合征，会增加细菌和真菌感染以及炎症/自身免疫并发症的风险。虽然历史上CGD与儿童早期死亡有关，但CGD患者的预期寿命和发病率已大大改善。现在许多CGD患者能顺利活到成年，并且已经发表了关于CGD成年患者队列的数据。然而，关于CGD患者妊娠管理、并发症和结局的报告却很少。此外，孕期侵袭性真菌感染的管理，包括新型三唑类抗真菌药物的使用，尚未得到充分描述。我们报告了一例患有CGD的孕妇在孕中期被诊断出肺部真菌感染的病例，该患者接受了多种抗真菌药物治疗，包括超过12周的艾沙康唑治疗，感染得以缓解，并足月分娩出一名健康的新生儿。
