Key Laboratory of Gastrointestinal Diseases of Gansu Province, The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China.
Emergency Intensive Care Unit, The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China.
Front Cell Infect Microbiol. 2023 Dec 15;13:1289235. doi: 10.3389/fcimb.2023.1289235. eCollection 2023.
Human infection with () is exceptionally rare. A 23-year-old female patient contracted both bacterial and infections during influenza A virus infection. Multiple etiological tests were performed repeatedly during hospitalization due to fluctuations in condition. On the 17th day after hospital admission, mold hyphae were discovered in the pathogen culture of the patient's bronchoalveolar lavage fluid during one of these examinations. The patient was suspected to have a filamentous fungal infection. Consequently, we further obtained sputum samples for fungal culture, which confirmed the diagnosis of infection. The patient, in this case, was in a critical condition, experiencing complications of lung abscess, pneumothorax, sepsis, and multiorgan failure. Despite prompt initiation of antifungal therapy including amphotericin B cholesteryl sulfate complex and isavuconazole upon detection of the fungal infection and concurrent administration of active organ function support treatment, the patient's condition rapidly deteriorated due to compromised immune function. Ultimately, on the 27th day of treatment, the patient succumbed to septic shock and multiple organ dysfunction syndrome. This is the first case of infection in our hospital. In this paper, we aim to raise awareness of infection and to emphasize that the possibility of this fungal infection should be considered in patients with severe pneumonia caused by influenza A virus and that empirical antifungal therapy should be given promptly when the patient has invasive lung damage.
人感染 () 极为罕见。一名 23 岁女性患者在感染甲型流感病毒期间同时感染了细菌和真菌感染。由于病情波动,患者在住院期间反复进行了多次病因学检查。入院第 17 天,其中一次检查中患者支气管肺泡灌洗液的病原体培养发现霉菌菌丝。怀疑患者患有丝状真菌感染。因此,我们进一步获取了痰液样本进行真菌培养,确诊了 感染。在这种情况下,患者病情危急,并发肺脓肿、气胸、脓毒症和多器官功能衰竭。尽管在检测到真菌感染时立即开始了抗真菌治疗,包括两性霉素 B 胆甾醇复合体和伊曲康唑,并同时给予积极的器官功能支持治疗,但由于免疫功能受损,患者病情迅速恶化。最终,在治疗的第 27 天,患者因感染性休克和多器官功能障碍综合征而死亡。这是我院首例 感染病例。本文旨在提高对 感染的认识,并强调在甲型流感病毒引起的重症肺炎患者中,应考虑到这种真菌感染的可能性,当患者出现侵袭性肺损伤时,应立即给予经验性抗真菌治疗。