非严重免疫功能低下患者的原发性侵袭性肠曲霉病

E. Gil, T. Ha, G. Suh, C. Chung, C. Park
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引用次数: 1

摘要

侵袭性曲霉病(IA)最常见于有危险因素的患者,如细胞毒性化疗、长时间中性粒细胞减少、皮质类固醇、移植和获得性免疫缺陷综合征。IA通常发生在呼吸道。肺外曲霉病通常是播散性感染的一部分,而原发性侵袭性肠曲霉病是非常罕见的。在此,我们报告一例免疫功能正常的53岁男性,在重症监护室(ICU)复发感染性休克,最终被诊断为侵袭性肠曲菌病,无传播。没有免疫疾病的患者很少考虑IA。因此,当这样的病例发生时,诊断被延误,临床结果往往很差。然而,有越来越多的文献报道无免疫疾病患者的IA病例,主要是ICU患者。危重患者应考虑原发性肠道曲霉病,特别是胃肠道黏膜屏障严重破坏的患者。
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Primary Invasive Intestinal Aspergillosis in a Non-Severely Immunocompromised Patient
Invasive aspergillosis (IA) is most commonly seen in patients with risk factors, such as cytotoxic chemotherapy, prolonged neutropenia, corticosteroids, transplantation and acquired immune deficiency syndrome. IA commonly occurs in the respiratory tract. Extrapulmonary aspergillosis is usually a part of a disseminated infection, and primary invasive intestinal aspergillosis is very rare. Herein, we report a case of an immunocompetent 53-year-old male who suffered recurrent septic shock in the intensive care unit (ICU) and was finally diagnosed as invasive intestinal aspergillosis without dissemination. IA is rarely considered for patients who do not have an immune disorder. Thus, when such cases do occur, the diagnosis is delayed and the clinical outcome is often poor. However, there is a growing literature reporting IA cases in patients without an immune disorder, mostly among ICU patients. Primary intestinal aspergillosis should be considered for critically ill patients, especially with severe disrupted gastrointestinal mucosal barrier.
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