第2部分:粘膜菌:专注于治疗治疗
Joseph P Lynch1, George G Zhanel2
1Division of Pulmonary, Critical Care Medicine, Allergy, and Clinical Immunology, Department of Internal Medicine, the David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Expert review of anti-infective therapy
|June 10, 2023
概括
粘菌菌 (MCR) 是一种危险的真菌感染. 氨乙烯的脂质配方是主要治疗,口服三醇作为替代品,以及手术干预和宿主免疫控制.
科学领域:
- 菌类学 菌类学是指菌类学.
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 粘菌菌 (MCR) 是一种罕见的,危及生命的真菌感染,主要影响免疫力低下的人.
- 高死亡率与侵入性和传播性MCR有关,尽管局部皮肤疾病的死亡率较低.
- 由于MCR的罕见性限制了随机对照治疗试验的可用性.
研究的目的:
- 审查和讨论目前的治疗选择,用于粘膜菌病.
- 为了突出阿特素B (LFAB) 的脂质配方作为主要治疗的作用.
- 探索口服三醇 (波萨可纳,伊萨夫可纳) 和手术除在MCR管理中的实用性.
主要方法:
- 在PubMed上进行了一项文献搜索,截至2022年12月.
- 关键词包括:侵袭性真菌感染,菌,粘菌菌,Mucorales,安福特瑞辛B,伊萨武可纳和波萨可纳.
- 该审查侧重于MCR的治疗策略.
主要成果:
- 脂配方的安福特素B (LFAB) 仍然是MCR治疗的基石.
- 口服三醇 (posaconazole, isavuconazole) 显示出作为逐步降低疗法或对LFAB耐药/不耐受病例的潜力.
- 早期的手术脱bridement 作为局部侵入性疾病的辅助措施至关重要.
结论:
- 在MCR中最佳生存需要控制诸如高血糖症和中性质衰竭等潜在疾病,并减少免疫抑制.
- LFAB是主要的治疗方法,三醇提供了替代性或辅助性作用.
- 手术干预是管理局部侵袭性粘膜瘤病的关键组成部分.
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