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[全身性真菌病患者的临床病程及危险因素]

[Clinical course and risk factors in patients with generalized mycoses].

作者信息

von Eiff M, Essink M, Fegeler W, Schellong S, Schmidt H, Hiddemann W, Büchner T, van de Loo J

机构信息

Abteilung Innere Medizin A, Universität Münster.

出版信息

Schweiz Med Wochenschr. 1988 Apr 23;118(16):584-91.

PMID:3381072
Abstract

A retrospective analysis of the clinical course of disseminated fungal infections in 32 patients revealed 25 cases of candidiasis, 5 patients with aspergillosis, and 2 with mixed fungal infections. All patients had undergone cytostatic therapy for malignant hematological diseases as the predisposing risk factor for fungal infection. 30 patients had severe granulocytopenia (less than 500/cmm). In addition, 30 patients had received broad spectrum antibiotics and 16 had been treated with corticosteroids. 17 of 32 patients were treated systemically with antimycotic drugs for proven fungal infection. No antimycotic agents were given to 15 patients because fungal infections were diagnosed only on post mortem examination. 19 patients succumbed to overwhelming disease, including 5 in spite of antimycotic therapy. Patients in whom systemic candidiasis was detected after recovery of granulocytopoeisis had a better prognosis than patients who developed systemic fungal infections during the period of ongoing severe granulocytopenia.

摘要

对32例播散性真菌感染患者的临床病程进行回顾性分析发现,念珠菌病25例,曲霉病5例,混合真菌感染2例。所有患者均因恶性血液病接受细胞抑制治疗,这是真菌感染的易感危险因素。30例患者有严重粒细胞减少(低于500/立方毫米)。此外,30例患者接受了广谱抗生素治疗,16例接受了皮质类固醇治疗。32例患者中有17例因确诊真菌感染而接受了抗真菌药物的全身治疗。15例患者未给予抗真菌药物,因为真菌感染仅在尸检时才被诊断出来。19例患者死于严重疾病,其中5例尽管接受了抗真菌治疗仍死亡。粒细胞生成恢复后检测到系统性念珠菌病的患者比在严重粒细胞减少持续期间发生系统性真菌感染的患者预后更好。

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