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真菌感染。

Fungal infections.

作者信息

Chimelli L, Mahler-Araujo M B

机构信息

Departamento de Patologia, Faculdade de Medicina de Ribeirao Preto, SP, Brasil.

出版信息

Brain Pathol. 1997 Jan;7(1):613-27. doi: 10.1111/j.1750-3639.1997.tb01078.x.

Abstract

Fungal infections have increased in frequency in the last decades because of the growing number of immunocompromised patients who survive longer periods of time than in the past, the widespread use of immunosuppressive drugs, a large aging population with increased numbers of malignancies, and the spread of AIDS. Although fungi are present everywhere, some mycoses predominate in the tropics, not only in view of warm temperature and humid climate, which favor their growth, but also because of inadequate hygienic and working conditions brought about by poverty. Mycotic diseases in the brain are usually secondary to infections elsewhere in the body, usually the lungs, less often from other extracranial sites, and in the vast majority of the cases spread via blood circulation. Only occasionally they result from direct extensions from infections of the sinuses or bone, and less frequently from prosthetic heart valves. Candida may be endogenous in origin, inhabiting the digestive tract. Most fungi cause basal meningitis or intraparenchymal abscesses. Direct extension from the cribriform plate cause necro-hemorrhagic lesions in the base of the frontal lobe. Although fungi are common in our environment, few are pathogenic. In this paper mycotic infections are divided into opportunistic and pathogenic; although most of the latter have also been described in immunosuppressed patients, some of those caused by opportunistic organisms, have also occurred in the absence of predisposing factors.

摘要

在过去几十年中,真菌感染的发生率有所增加,这是因为免疫功能低下的患者数量不断增多,他们的存活时间比过去更长,免疫抑制药物的广泛使用,老年人口增多导致恶性肿瘤患者数量增加,以及艾滋病的传播。尽管真菌无处不在,但一些真菌病在热带地区更为常见,这不仅是因为温暖的温度和潮湿的气候有利于它们的生长,还因为贫困导致卫生和工作条件不佳。脑部真菌病通常继发于身体其他部位的感染,通常是肺部,较少来自其他颅外部位,并且在绝大多数情况下是通过血液循环传播的。只有偶尔它们是由鼻窦或骨骼感染直接蔓延引起的,更少情况下是由人工心脏瓣膜引起的。念珠菌可能起源于内源性,寄居于消化道。大多数真菌会引起基底脑膜炎或脑实质内脓肿。从筛板直接蔓延会导致额叶底部出现坏死性出血性病变。尽管真菌在我们的环境中很常见,但具有致病性的却很少。在本文中,真菌感染分为机会性感染和致病性感染;尽管大多数致病性感染也在免疫抑制患者中有所描述,但一些由机会性微生物引起的感染也会在没有易感因素的情况下发生。

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本文引用的文献

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Intramedullary spinal cord paracoccidioidomycosis. Report of two cases.脊髓内副球孢子菌病。两例报告。
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Aspergillus sinusitis in patients with AIDS: report of three cases and review.
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