Tritz D M, Woods G L
Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha.
Clin Infect Dis. 1993 Jan;16(1):118-22. doi: 10.1093/clinids/16.1.118.
Aspergillus terreus is widespread in the environment but only uncommonly infects humans. It can cause cutaneous and subcutaneous infections, and several cases of local invasive disease have been reported; to our knowledge, however, only five cases of disseminated disease have been documented previously. We describe here four additional patients with disseminated disease caused by A. terreus. All four had an underlying hematologic or lymphoreticular malignancy, were immunocompromised secondary to prolonged neutropenia or immunosuppressive therapy, and had invasive pulmonary disease (a circumstance supporting a respiratory route of infection). Despite treatment with amphotericin B, all four patients died. When recovered from clinical specimens, A. terreus should not routinely be dismissed as a saprobe, particularly in immunocompromised hosts.
土曲霉在环境中广泛存在，但很少感染人类。它可引起皮肤和皮下感染，并且已有数例局部侵袭性疾病的报道；然而，据我们所知，此前仅有5例播散性疾病的记录。我们在此描述另外4例由土曲霉引起的播散性疾病患者。这4例患者均有潜在的血液系统或淋巴网状系统恶性肿瘤，因长期中性粒细胞减少或免疫抑制治疗而免疫功能低下，且均有侵袭性肺部疾病（这一情况支持感染的呼吸道途径）。尽管接受了两性霉素B治疗，这4例患者均死亡。当从临床标本中分离出土曲霉时，不应常规地将其视为腐生菌而不予考虑，尤其是在免疫功能低下的宿主中。
