Breton P, Germaud P, Morin O, Audouin A F, Milpied N, Harousseau J L
Service de Pneumologie, Hôpital Laënnec, St Herblain.
Rev Pneumol Clin. 1998 Oct;54(5):253-7.
Patients with hematology disease in post-chemotherapy medullary aplasia are susceptible to life-threatening bronchopulmonary mycoses, especially aspergillosis. Other less common pulmonary mycoses are also observed. We report 4 cases due to Penicillium purpurogenum, Acromonium strictum and Scedosporium apiospermum (n = 2) infections. These unusual fungi appear to be emerging as pathogens in this population. They have common ubiquitous, opportunistic and low pathogenicity characteristics in immunocompetent subjects. The major risk factor is neutropenia. Isolating one of these fungi in an immunodepressed patient modifies management protocols since certain unusual fungi such as Scedosporium are resistant to amphotericin B.
化疗后骨髓再生障碍的血液病患者易患危及生命的支气管肺真菌病,尤其是曲霉病。也观察到其他不太常见的肺部真菌病。我们报告了4例由产紫青霉、紧密顶孢霉和尖端赛多孢(2例)感染引起的病例。这些不常见的真菌似乎正在成为该人群中的病原体。它们在免疫功能正常的个体中具有常见的普遍存在、机会性和低致病性特征。主要危险因素是中性粒细胞减少。在免疫抑制患者中分离出这些真菌之一会改变治疗方案,因为某些不常见的真菌如尖端赛多孢对两性霉素B耐药。