O'Regan Siobhan, O'Kelly Brendan, Reidy Paul, O'Toole Aoibhlinn, Caird John, McNally Cora, McConkey Samuel, De Barra Eoghan
Infectious Diseases Service, Beaumont Hospital, D09 V2N0 Dublin, Ireland.
International Health and Tropical Medicine Department, Royal College of Surgeons Ireland University of Medicine and Health Sciences, D02 YN77 Dublin, Ireland.
J Fungi (Basel). 2022 May 25;8(6):557. doi: 10.3390/jof8060557.
This case highlights the use of (1,3)-beta-d glucan to direct treatment of a cervical spinal cord Aspergillus fumigatus infection in a 22-year-old woman immunocompromised due to steroid and anti-TNF therapy in the context of ulcerative colitis and interferon gamma deficiency. A 4-year treatment course requiring neurosurgical intervention on four occasions and prolonged antifungal therapy, including isavuconazole, resulted in clinical cure with a corresponding decrease in CSF beta-d-glucan to <30 pg/mL. Serum and CSF galactomannan levels were not elevated at any point during the clinical course.
该病例突出了（1,3）-β -D-葡聚糖在指导一名22岁女性颈椎脊髓烟曲霉感染治疗中的应用。该女性因溃疡性结肠炎接受类固醇和抗TNF治疗以及存在γ-干扰素缺乏而免疫功能低下。一个需要四次神经外科干预和长期抗真菌治疗（包括使用isavuconazole）的4年疗程，最终实现了临床治愈，同时脑脊液β -D-葡聚糖相应下降至<30 pg/mL。在临床过程中的任何时间点，血清和脑脊液半乳甘露聚糖水平均未升高。
