Vennewald I, Seebacher C, Roitzsch E
Hautklinik des Städtischen Klinikums Dresden-Friedrichstadt, Dresden, FR, Germany.
Mycoses. 1998 Mar-Apr;41(3-4):125-32. doi: 10.1111/j.1439-0507.1998.tb00313.x.
In our mycological laboratory we saw an increase in the occurrence of Candida glabrata isolates from 0.5% in 1990 to 22.2% in 1996, mainly isolates of high-risk patients of the intensive care unit and the oncological ward. We were interested to analyse whether this increase in C. glabrata was also demonstrable in a corresponding number of deep-seated candidosis. Eighteen patients were autopsied and examined microscopically. In all patients, repeated occurrence of C. glabrata, with or without C. albicans during the hospital treatment, was found. Serology and fungal cultures of these intensive care/oncological patients were indicative of invasive candidosis. In 12 of these 18 patients, there was no evidence of deep-seated candidosis at autopsy. Three patients had a typical aspergillosis of the lungs, which was not diagnosed during their hospital treatment. In five patients (two of them with an aspergillosis of the lungs), we found sporadic yeast cells in kidney or lung tissue, characterized by size and missing pseudomycelium as C. glabrata. In no case was a cellular intravital defensive reaction against these yeast cells found. Therefore, we interpreted the demonstration of C. glabrata in tissues as a transitory fungaemia and not as a deep-seated C. glabrata mycosis.
在我们的真菌学实验室中，我们发现光滑念珠菌分离株的出现率从1990年的0.5%上升到了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。我们有兴趣分析这种光滑念珠菌的增加在相应数量的深部念珠菌病中是否也能得到证实。对18例患者进行了尸检并进行显微镜检查。在所有患者中，均发现住院治疗期间反复出现光滑念珠菌，伴或不伴有白色念珠菌。这些重症监护/肿瘤科患者的血清学和真菌培养表明存在侵袭性念珠菌病。在这18例患者中的12例尸检中，没有深部念珠菌病的证据。3例患者患有典型的肺部曲霉菌病，在住院治疗期间未被诊断出来。在5例患者（其中2例患有肺部曲霉菌病）中，我们在肾脏或肺组织中发现了散在的酵母细胞，其特征为大小和无假菌丝，符合光滑念珠菌。在任何情况下都未发现针对这些酵母细胞的细胞内活体防御反应。因此，我们将组织中光滑念珠菌的出现解释为短暂性真菌血症，而非深部光滑念珠菌病。
