Vennewald I, Seebacher C, Roitzsch E
Hautklinik, Krankenhaus Dresden-Friedrichstadt, Städtisches Klinikum, Dresden, BR Deutschland.
Mycoses. 1997;40 Suppl 1:97-103. doi: 10.1111/j.1439-0507.1997.tb00550.x.
In our mycological laboratory we saw an increase of Candida glabrata isolates from 0.5% in 1993 to 22.2% in 1996, mainly isolates of high risk patients of intensive care units and oncological wards. We were interested to know whether this increase of C. glabrata is also corresponding to the number of endomycoses. Eighteen patients have been autopsied and examined histologically. During the hospital course we found repeatedly in all patients C. glabrata with or without C. albicans. Serological and culture results of this intensive care/oncological patients were indicative of an invasive endomycosis. In 12 of 18 patients there was no evidence of an invasive mycosis in autopsy tissues. Three patients had a typical aspergillosis of the lungs, which was not diagnosed during hospital course. In 5 patients, two of them with aspergillosis of the lungs, we found in kidney or lung tissue sporadic yeast cells, typified by size and missing pseudomycelium as C. glabrata. In no case a tissue reaction as an intravital defense reaction against these yeast cells was observed. Therefore, we interpreted the findings of C. glabrata in tissues as representing a transient fungemia and not as an endomycosis due to C. glabrata.
在我们的真菌学实验室中，我们发现光滑念珠菌的分离率从1993年的0.5%上升至1996年的22.2%，主要来自重症监护病房和肿瘤科病房的高危患者。我们想了解光滑念珠菌的这种增加是否也与深部真菌病的数量相对应。对18例患者进行了尸检并进行组织学检查。在住院过程中，我们在所有患者中反复发现光滑念珠菌，有无白色念珠菌均有。这些重症监护/肿瘤科患者的血清学和培养结果表明存在侵袭性深部真菌病。18例患者中有12例在尸检组织中没有侵袭性真菌病的证据。3例患者患有典型的肺部曲霉菌病，在住院过程中未被诊断出来。在5例患者中，其中2例患有肺部曲霉菌病，我们在肾脏或肺组织中发现了散在的酵母细胞，其大小和无假菌丝体特征符合光滑念珠菌。在任何情况下，均未观察到针对这些酵母细胞的作为活体防御反应的组织反应。因此，我们将组织中光滑念珠菌的发现解释为代表短暂性真菌血症，而非由光滑念珠菌引起的深部真菌病。
