Stahel R A, Vogt P, Schüler G, Rüttner J R, Frick P, Oelz O
Schweiz Med Wochenschr. 1983 Jan 15;113(2):44-6.
Between July 1973 and June 1981 systemic fungal infections were found in 27 of 270 autopsies of patients with hematologic malignancies: in 16 aspergillosis, in 6 candidiasis, in one aspergillosis and candidiasis, and in 4 mucormycosis. The frequency increased from 6% during the first 6 years to 25% during the last 2 years (p = 0.025). Fever despite antibiotics and new pulmonary infiltrates were the major symptoms. In only 6 of 16 patients did microbiological findings support the clinically suspected diagnosis. Systemic fungal infections were the principal cause of death in 12 patients. Because of the difficulty of establishing the diagnosis, empiric antimycotic therapy should be started promptly on clinical suspicion in patients with neutropenia and fever despite antibiotics.
1973年7月至1981年6月期间，在对270例血液系统恶性肿瘤患者进行的尸检中，发现27例存在系统性真菌感染：16例为曲霉菌病，6例为念珠菌病，1例为曲霉菌病合并念珠菌病，4例为毛霉菌病。感染率从前6年的6%增至最后2年的25%（p = 0.025）。主要症状为使用抗生素后仍发热以及新出现的肺部浸润。16例患者中只有6例的微生物学检查结果支持临床疑似诊断。系统性真菌感染是12例患者的主要死因。鉴于确诊困难，对于出现中性粒细胞减少且使用抗生素后仍发热的患者，一旦临床怀疑，应立即开始经验性抗真菌治疗。
