Meunier-Carpentier F, Kiehn T E, Armstrong D
Am J Med. 1981 Sep;71(3):363-70. doi: 10.1016/0002-9343(81)90162-5.
Fungemias were reviewed in 110 immunocompromised patients hospitalized between November 1, 1974, and December 31, 1977, a Memorial Sloan-Kettering Cancer Center (MSKCC). The incidence of Candida tropicalis fungemia increased each year. Seventy-six percent of the patients with C. tropicalis fungemia and 32.5 percent of those with C. albicans fungemia had either leukemia or lymphoma. Seventy-seven percent of the C. parapsilosis fungemias were related to total parenteral nutrition. Thirty-seven percent of the patients with C. albicans fungemia were receiving oral prophylactic nystatin therapy. The source of fungemia was often difficult to determine: in 60 percent of the patients, only blood cultures were positive for C. tropicalis or Torulopsis glabrata; no cultures were positive for the fungus from any other site before the episode occurred. Serologic tests, including a highly sensitive passive hemagglutination test, showed fourfold increases in titer only inconsistently. A passive hemagglutination-inhibition test for circulating antigen was positive in 50.9 percent of 57 patients with fungemia who were tested and may be a valid indication for treatment. Fungemia usually represented a severe and often fatal disease. The over-all mortality of the 110 patients with fungemia was 79 percent whereas only 23 percent of the patients with C. parapsilosis fungemia died. Among the patients who received more than 200 mg of amphotericin B, 71 percent died despite treatment.
对1974年11月1日至1977年12月31日期间在纪念斯隆-凯特琳癌症中心（MSKCC）住院的110例免疫功能低下患者的真菌血症进行了回顾。热带念珠菌真菌血症的发病率逐年上升。76%的热带念珠菌真菌血症患者和32.5%的白色念珠菌真菌血症患者患有白血病或淋巴瘤。77%的近平滑念珠菌真菌血症与全胃肠外营养有关。37%的白色念珠菌真菌血症患者正在接受口服预防性制霉菌素治疗。真菌血症的来源往往难以确定：在60%的患者中，仅血培养显示热带念珠菌或光滑球拟酵母菌呈阳性；在发病前，任何其他部位的培养物均未发现该真菌呈阳性。血清学检测，包括高度敏感的被动血凝试验，仅在少数情况下显示滴度有四倍升高。对57例接受检测的真菌血症患者进行的循环抗原被动血凝抑制试验中，50.9%呈阳性，这可能是治疗的有效指征。真菌血症通常是一种严重且往往致命的疾病。110例真菌血症患者的总体死亡率为79%，而近平滑念珠菌真菌血症患者的死亡率仅为23%。在接受超过200mg两性霉素B治疗的患者中，尽管进行了治疗，仍有71%死亡。
