Hummel M, Schüler S, Hempel S, Rees W, Hetzer R
Division of Thoracic and Cardiovascular Surgery, German Heart Institute Berlin.
Mycoses. 1993 Nov-Dec;36(11-12):425-8. doi: 10.1111/j.1439-0507.1993.tb00733.x.
Obstructive bronchial aspergillosis is a rarely observed consequence of Aspergillus infection. It occurs not only in patients with the acquired immunodeficiency syndrome (AIDS), but also after heart transplantation (HTx) if T cells are reduced markedly by the application of antithymocyte globulin (ATG) in addition to immunosuppression with corticosteroids. In contrast to invasive aspergillosis or Aspergillus tracheobronchitis, the course of this form of Aspergillus infection may not be accompanied by symptoms, because bronchial inflammation with pseudomembranes, ulcers or destruction of mucosa and intrapulmonary infiltrates are absent. To prevent invasive aspergillosis following HTx, intensive antifungal therapy is necessary in cases of bronchial obstructive aspergillosis, because this form of Aspergillus infection seems to represent a stage before recognizable invasive disease, as in other immunocompromised patients.
阻塞性支气管曲霉病是曲霉感染罕见的后果。它不仅发生在获得性免疫缺陷综合征（AIDS）患者中，也发生在心脏移植（HTx）后，如果除了使用皮质类固醇进行免疫抑制外，还应用抗胸腺细胞球蛋白（ATG）使T细胞显著减少。与侵袭性曲霉病或曲霉气管支气管炎不同，这种形式的曲霉感染过程可能不伴有症状，因为不存在伴有假膜的支气管炎症、溃疡或粘膜破坏以及肺内浸润。为预防HTx后发生侵袭性曲霉病，对于支气管阻塞性曲霉病患者，强化抗真菌治疗是必要的，因为这种形式的曲霉感染似乎代表了可识别的侵袭性疾病之前的一个阶段，就像其他免疫功能低下的患者一样。
