Newman S L, Flanigan T P, Fisher A, Rinaldi M G, Stein M, Vigilante K
Brown University, AIDS Program, Providence, Rhode Island.
Clin Infect Dis. 1994 Oct;19(4):684-6. doi: 10.1093/clinids/19.4.684.
Eight cases of severe mucosal candidiasis in patients with AIDS who were taking fluconazole at a dosage of 400-800 mg/d are described. Candida albicans alone or in conjunction with Torulopsis glabrata or Candida stellatoidea was isolated from each patient. In vitro susceptibility testing demonstrated resistance to fluconazole in all eight cases. All tested isolates were susceptible to amphotericin B, and six of eight isolates tested were susceptible to itraconazole. All individuals were severely immunocompromised (CD4 lymphocyte counts: mean, 15/mm3; range, 6-39/mm3) and had been receiving prophylaxis with fluconazole for a mean of only 3 months (range, 1-7 months). The occurrence of candidal mucositis in patients receiving high doses of fluconazole is a matter of concern that requires further study in regard to the causes, prevention, and treatment of the disease.
本文描述了8例艾滋病患者发生严重黏膜念珠菌病的情况，这些患者正在服用剂量为400 - 800毫克/天的氟康唑。从每位患者中分离出了白色念珠菌，其单独存在或与光滑球拟酵母菌或星状念珠菌共同存在。体外药敏试验显示，所有8例均对氟康唑耐药。所有测试菌株对两性霉素B敏感，8株测试菌株中有6株对伊曲康唑敏感。所有个体均严重免疫功能低下（CD4淋巴细胞计数：平均为15/立方毫米；范围为6 - 39/立方毫米），且接受氟康唑预防治疗的平均时间仅为3个月（范围为1 - 7个月）。接受高剂量氟康唑治疗的患者发生念珠菌性黏膜炎的情况值得关注，需要对该疾病的病因、预防和治疗进行进一步研究。
