Höchter W, Seeliger H P, Keilig W, Hemmer E, Weingart J, Ottenjann R
Dtsch Med Wochenschr. 1983 Mar 18;108(11):416-8. doi: 10.1055/s-2008-1069570.
Fungal cultures, unstained smears and histological assessment of endoscopically obtained particles from ulcers in rectum, colon or terminal ileum were obtained in a prospective study of possible fungal infection in 78 patients with colitis of various aetiologies (Crohn's disease - 46; ulcerative colitis - 21; infectious colitis - 5; ischaemic colitis - 2; radiation colitis - 1; non-classifiable colitis - 3). Positive fungal culture was obtained in 13 patients (16.7%). The germ count was low (2--8 colonies per biopsy piece). The demonstrated fungi were almost exclusively Candida or Torulopsis. The potentially pathogenic mycelia phase of the fungi were never seen, either histologically or in unstained preparations. Stool specimens, obtained at the same time, were examined in 54 patients: positive cultures were obtained in 14 (25.9%). Only rarely were there concordance of positive fungal findings in both ulcer particles and faeces. It is concluded that (1) there is little danger of secondary fungal infection in colitis of various aetiologies; (2) positive faecal fungal culture is apparently of no pathogenic significance if the germ count is less than 10(6) per gram stool; (3) in the lower as well as the upper gastro-intestinal tract pathogenic fungal infection can be demonstrated only by endoscopy and biopsy.
在一项针对78例各种病因所致结肠炎(克罗恩病46例、溃疡性结肠炎21例、感染性结肠炎5例、缺血性结肠炎2例、放射性结肠炎1例、无法分类的结肠炎3例)患者可能存在真菌感染的前瞻性研究中,获取了直肠、结肠或回肠末端溃疡处经内镜获取颗粒的真菌培养物、未染色涂片及组织学评估结果。13例患者(16.7%)真菌培养呈阳性。菌数较低(每个活检组织块有2 - 8个菌落)。所证实的真菌几乎均为念珠菌或球拟酵母菌。无论是在组织学检查还是未染色标本中,均未见真菌的潜在致病菌丝阶段。同时对54例患者的粪便标本进行了检查:14例(25.9%)培养呈阳性。溃疡颗粒和粪便中真菌检查结果呈阳性的情况很少一致。得出以下结论:(1)各种病因所致结肠炎继发真菌感染的风险较小;(2)如果每克粪便中菌数少于10⁶,粪便真菌培养阳性显然无致病意义;(3)在上消化道和下消化道,仅通过内镜检查和活检才能证实致病性真菌感染。