McAdams H P, Rosado-de-Christenson M L, Templeton P A, Lesar M, Moran C A
Department of Radiology, Walter Reed Army Medical Center, Washington, DC, USA.
Radiographics. 1995 Mar;15(2):271-86. doi: 10.1148/radiographics.15.2.7761633.
Fungi of the genera Aspergillus, Candida, and Cryptococcus and the class Zygomycetes are the most common causes of thoracic opportunistic mycoses in immunocompromised patients. Candidiasis and zygomycosis usually manifest as severe, often life-threatening, pneumonias. Aspergillus species are commonly implicated as the causative organisms in a broad spectrum of pulmonary disorders, ranging from hypersensitivity lung disease in atopic patients to invasive pneumonia in immunocompromised patients. Cryptococcus neoformans infects both immunologically normal and abnormal patients, with variable clinical and radiologic findings. The diagnosis of an opportunistic mycosis requires familiarity with the epidemiology of the disease, the various modes of clinical presentation, and the full spectrum of radiologic manifestations. Because many of these fungi may normally colonize in the upper respiratory tract, sputum cultures are considered diagnostically unreliable. Instead, definitive diagnosis hinges on either culture of the fungus from infected tissue or demonstration of the organism at microscopic examination.
曲霉属、念珠菌属、隐球菌属真菌以及接合菌纲是免疫功能低下患者胸部机会性真菌病最常见的病因。念珠菌病和接合菌病通常表现为严重的、往往危及生命的肺炎。曲霉属真菌通常被认为是多种肺部疾病的致病生物，范围从特应性患者的过敏性肺病到免疫功能低下患者的侵袭性肺炎。新型隐球菌可感染免疫功能正常和异常的患者，临床表现和影像学表现各不相同。机会性真菌病的诊断需要熟悉该疾病的流行病学、各种临床表现方式以及所有影像学表现。由于这些真菌中的许多通常可在上呼吸道定植，因此痰培养在诊断上被认为不可靠。相反，明确诊断取决于从感染组织中培养出真菌或在显微镜检查中发现该生物体。
