Krcmery V, Kunova E, Jesenska Z, Trupl J, Spanik S, Mardiak J, Studena M, Kukuckova E
Department of Medicine, University of Tranava, Slovak Republic.
Support Care Cancer. 1996 Jan;4(1):39-45. doi: 10.1007/BF01769874.
Twenty systemic mold infections due to hyphic fungi (molds) arising within the last 5 years in a 60-bed cancer department are analyzed. The most frequent risk factors were plants in ward (75%), prior therapy with broad spectrum antibiotics (70%), catheter insertion (70%), acute leukemia (65%) and neutropenia (60%). Before death, a definitive diagnosis was made in 40%, and a presumptive diagnosis in 60% of patients: post mortem the presumptive antemortem diagnosis was confirmed in all cases (100% of patients). Aspergillosis was the most common invasive fungal disease (55%), followed by mucormycosis (15%), fusariosis (15%), and acremoniosis (10%). Of 20 patients, 8 (40%) were cured or improved after antifungal therapy with amphotericin B, ambisome and/or itraconazole; 8/20 (40%) died of fungal infection and 4/20 (20%) of underlying disease with fungal infection. Even though the diagnosis was made and antifungal therapy started before death in 15/ 20 (75%), invasive mold infection had a 60% overall mortality in patients with malignant disease.
对某拥有60张床位的癌症科室在过去5年内发生的20例由丝状真菌（霉菌）引起的系统性霉菌感染进行了分析。最常见的危险因素为病房内有植物（75%）、先前使用过广谱抗生素（70%）、插入导管（70%）、急性白血病（65%）和中性粒细胞减少（60%）。在死亡前，40%的患者得到了确诊，60%的患者为推定诊断：尸检时所有病例（100%的患者）生前的推定诊断均得到证实。曲霉病是最常见的侵袭性真菌病（55%），其次是毛霉病（15%）、镰刀菌病（15%）和支顶孢霉病（10%）。20例患者中，8例（40%）在接受两性霉素B、安必素和/或伊曲康唑抗真菌治疗后治愈或病情改善；8/20（40%）死于真菌感染，4/20（20%）死于合并真菌感染的基础疾病。尽管15/20（75%）的患者在死亡前做出了诊断并开始了抗真菌治疗，但侵袭性霉菌感染在恶性疾病患者中的总死亡率仍为60%。
