Kaben U
Institut für Medizinische Mikrobiologie am Klinkikum der Universität Rostock.
Z Arztl Fortbild Qualitatssich. 1998 Apr;92(3):169-73.
An invasive mycosis may cause death in high-risk patients. An early systemic antimycotic therapy can save life. Therefore, a continuous mycological monitoring in one week intervals is necessary in high-risk patients beginning with the day of admission. This monitoring should be done three to five times a week when an organ manifestation is suspected. Due to the continuous monitoring, the assignment of the results is much easier for the clinician. The goal of the mycological monitoring is to obtain an early hint of a fungus infection. The results of the culture as well as serum titers of antigen and antibodies have to be interpreted in connection with the clinical picture of the underlying disease and the actual risk of infection. Negative results do not rule out a mycosis! Positive results do not always proof an invasive mycosis. Only by interpreting the time course of the mycological findings and the patient's clinical status, an invasive mycosis may be diagnosed with some certainty. In any case, additional procedures like radiological techniques (i.e. CT-scan), histology etc. should be used.
侵袭性真菌病可能导致高危患者死亡。早期进行全身抗真菌治疗可挽救生命。因此，从入院当天起，高危患者有必要每隔一周进行一次连续的真菌学监测。当怀疑有器官表现时，这种监测应每周进行三至五次。由于进行了连续监测，临床医生对结果的判断要容易得多。真菌学监测的目的是尽早发现真菌感染迹象。培养结果以及抗原和抗体的血清滴度必须结合基础疾病的临床表现和实际感染风险来解读。阴性结果不能排除真菌病！阳性结果也不总是能证明存在侵袭性真菌病。只有通过解读真菌学检查结果的时间进程和患者的临床状况，才能较为确定地诊断侵袭性真菌病。在任何情况下，都应采用其他检查手段，如放射学技术（即CT扫描）、组织学检查等。
