罕见的并发肺部感染：抗MDA5抗体阳性皮肌炎患者中的情况
Uncommon concurrent pulmonary infections: and in an Anti-MDA5 antibody-positive dermatomyositis patient.
作者信息
Fukumura Maaya, Hiwa Ryosuke, Yukawa Satomi, Tsuchido Yasuhiro, Yoshifuji Hajime, Morinobu Akio
机构信息
Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Infection Control and Prevention, Kyoto University Hospital, Kyoto, Japan.
出版信息
Med Mycol Case Rep. 2024 Dec 5;47:100689. doi: 10.1016/j.mmcr.2024.100689. eCollection 2025 Mar.
Abstract
A 59-year-old female with anti-MDA5 antibody-positive dermatomyositis was treated with prednisolone, tacrolimus, cyclophosphamide, tofacitinib, and plasma exchange. Five months post-treatment, elevated β-D-glucan levels and a pulmonary shadow on CT were noted. was identified, leading to voriconazole initiation. A new pulmonary cavity lesion later revealed . Considering voriconazole resistance, terbinafine was added, resulting in clinical improvement. Vigilant infection monitoring is crucial during anti-MDA5 antibody-positive dermatomyositis treatment.
摘要
一名59岁抗MDA5抗体阳性皮肌炎女性患者接受了泼尼松龙、他克莫司、环磷酰胺、托法替布治疗及血浆置换。治疗后5个月，发现β-D-葡聚糖水平升高及CT显示肺部有阴影。确诊后开始使用伏立康唑。后来发现一个新的肺空洞病变。考虑到伏立康唑耐药，加用了特比萘芬，临床症状改善。在抗MDA5抗体阳性皮肌炎治疗期间，警惕感染监测至关重要。
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本文引用的文献
1
Mortality risk in patients with anti-MDA5 dermatomyositis is related to rapidly progressive interstitial lung disease and anti-Ro52 antibody.
Arthritis Res Ther. 2023 Jul 24;25(1):127. doi: 10.1186/s13075-023-03100-z.
2
Case report: COVID-19-associated mucormycosis co-infection with : The first case and review on multiple fungal co-infections during COVID-19 pandemic.
Front Med (Lausanne). 2023 Mar 16;10:1078970. doi: 10.3389/fmed.2023.1078970. eCollection 2023.
3
Infection Risk in Patients with Dermatomyositis Associated with Anti-MDA5 Antibodies: A Historical Cohort Study.
Biomedicines. 2022 Dec 8;10(12):3176. doi: 10.3390/biomedicines10123176.
4
Dual fungal infection with and : A pathogenetic diagnosis elucidated after two decades by sequential examinations.
Clin Case Rep. 2021 Jan 18;9(3):1383-1386. doi: 10.1002/ccr3.3775. eCollection 2021 Mar.
5
Global guideline for the diagnosis and management of rare mould infections: an initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology and the American Society for Microbiology.
Lancet Infect Dis. 2021 Aug;21(8):e246-e257. doi: 10.1016/S1473-3099(20)30784-2. Epub 2021 Feb 16.
6
and Infections: Contemporary Microbiological Tools for the Diagnosis of Invasive Disease.
J Fungi (Basel). 2021 Jan 4;7(1):23. doi: 10.3390/jof7010023.
7
Eradication of Osteomyelitis of the Wrist with Combination Antifungal Therapy, Voriconazole Bone Cement, and Surgical Debridement.
Case Rep Orthop. 2020 Sep 17;2020:8271471. doi: 10.1155/2020/8271471. eCollection 2020.
8
Antifungal Susceptibility Profiles and Drug Resistance Mechanisms of Clinical Lomentospora prolificans Isolates.
Antimicrob Agents Chemother. 2020 Oct 20;64(11). doi: 10.1128/AAC.00318-20.
9
Efficacy of plasma exchange in anti-MDA5-positive dermatomyositis with interstitial lung disease under combined immunosuppressive treatment.
Rheumatology (Oxford). 2020 Nov 1;59(11):3284-3292. doi: 10.1093/rheumatology/keaa123.
10
Voriconazole plus terbinafine combination antifungal therapy for invasive Lomentospora prolificans infections: analysis of 41 patients from the FungiScope® registry 2008-2019.
Clin Microbiol Infect. 2020 Jun;26(6):784.e1-784.e5. doi: 10.1016/j.cmi.2020.01.012. Epub 2020 Jan 20.
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