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肾侵袭性曲菌瘤:艾滋病患者中的罕见感染。

Renal invasive aspergilloma: unusual infection in AIDS.

作者信息

Fiteni I, Crusells M J, Cuesta J, Letona S

机构信息

Department of Internal Medicine, Hospital Clinico Universitario of Zaragoza, Spain.

出版信息

J Infect. 1996 Jul;33(1):61-3. doi: 10.1016/s0163-4453(96)92852-2.

Abstract

Invasive aspergillosis is a devastating infection that mainly affects immunocompromised hosts. Nevertheless it is not a common infection in AIDS probably due to specific immune aspects. Even more rare in this group of patients is infection limited to the kidney without dissemination as occurred in our case reported here. He had heroin addiction, AIDS in advanced stage C3, neutropenia and received antifungal prophyllaxis as predisposing factors to aspergillosis. Despite correct therapy with Amphotericine B and drainage of one of the abscesses, he died due to antibiotic side-effects and persistence of not-drained contralateral abscess. Our experience supports the fact that we should have a high index of suspicion for fungal aetiology in kidney infection in AIDS patients with predisposing factors discussed in the text, in order to make early diagnosis and to establish prompt aggressive antifungal therapy supported by drainage of fungus collections, or even nephrectomy if required.

摘要

侵袭性曲霉病是一种严重的感染,主要影响免疫功能低下的宿主。然而,它在艾滋病患者中并非常见感染,可能与特定的免疫因素有关。在这组患者中,像我们报道的病例那样局限于肾脏而无播散的感染更为罕见。他有海洛因成瘾、处于C3晚期的艾滋病、中性粒细胞减少症,并且接受抗真菌预防治疗,这些都是曲霉病的易感因素。尽管使用两性霉素B进行了正确治疗并引流了其中一个脓肿,但他因抗生素副作用和对侧未引流脓肿的持续存在而死亡。我们的经验支持这样一个事实,即对于文中讨论的有易感因素的艾滋病患者的肾脏感染,我们应该对真菌病因有高度的怀疑指数,以便早期诊断并建立由真菌聚积物引流支持的迅速积极的抗真菌治疗,甚至在必要时进行肾切除术。

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