误吸大米后因门德尔松综合征导致β-D-葡聚糖和曲霉半乳甘露聚糖水平出现假阳性升高。
False-positive Elevation of Beta-D-glucan and Aspergillus Galactomannan Levels Due to Mendelson's Syndrome after Rice Aspiration.
作者信息
Yamamoto Tasuku, Oishi Keiji, Suizu Junki, Murakawa Keita, Hisamoto Yukari, Fujii Tetsuya, Harada Misa, Chikumoto Ayumi, Kikuchi Yujiro, Hamada Kazuki, Uehara Sho, Ohata Syuichiro, Murata Yoriyuki, Sakamoto Kenji, Yamaji Yoshikazu, Asami-Noyama Maki, Edakuni Nobutaka, Kakugawa Tomoyuki, Hirano Tsunahiko, Matsunaga Kazuto
机构信息
Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Japan.
Department of Medicine and Clinical Science, Graduate School of Medicine, Yamaguchi University, Japan.
出版信息
Intern Med. 2022 Oct 1;61(19):2935-2939. doi: 10.2169/internalmedicine.8805-21. Epub 2022 Mar 19.
Both 1,3-beta-D-glucan (BDG) and galactomannan (GM) are polysaccharide components of the fungal cell wall. Although elevated levels of serum BDG and Aspergillus GM suggest invasive fungal infection or Pneumocystis pneumonia and aspergillosis, respectively, it is also necessary to consider the possibility of false-positives. We herein report a 68-year-old man with marked elevation in serum BDG and GM levels accompanied by Mendelson's syndrome after rice aspiration. With the improvement of Mendelson's syndrome, his serum BDG and GM levels decreased. The false-positive serum BDG and GM findings may have been due to his aspiration of food containing them. It is important to take a detailed history of aspiration in addition to making a conventional differential diagnosis in patients with pneumonia with elevated serum BDG and GM levels.
1,3-β-D-葡聚糖（BDG）和半乳甘露聚糖（GM）均为真菌细胞壁的多糖成分。虽然血清BDG水平升高提示侵袭性真菌感染，而曲霉GM升高分别提示肺孢子菌肺炎和曲霉病，但也有必要考虑假阳性的可能性。我们在此报告一名68岁男性，在误吸米饭后出现血清BDG和GM水平显著升高，并伴有门德尔松综合征。随着门德尔松综合征的改善，他的血清BDG和GM水平下降。血清BDG和GM结果出现假阳性可能是由于他误吸了含有这些物质的食物。除了对血清BDG和GM水平升高的肺炎患者进行常规鉴别诊断外，详细了解误吸病史也很重要。
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