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移植患者的深皮肌菌:诊断和治疗的挑战
Chloé Bertin1, Emilie Sitterlé1, Anne Scemla2
1Unité de Parasitologie-Mycologie, Service de Microbiologie clinique, GHU Necker-Enfants-Malades, Assistance Publique des Hôpitaux de Paris (APHP), Paris, France.
Medical mycology
|January 16, 2024
概括
深皮性真菌菌 (DCM) 是一种罕见的真菌感染. 这项研究发现多种真菌物种在移植接受者中引起DCM,强调需要准确的诊断和量身定制的抗真菌治疗.
科学领域:
- 医学真菌学 医学真菌学
- 传染性疾病 传染性疾病
- 移植手术 移植手术
背景情况:
- 深层皮肤真菌 (DCM) 是一种罕见的真菌感染,会影响更深层的皮肤.
- 增加的DCM发病率可能与越来越多的固体器官移植受体人口有关.
- 在移植接受者中优化DCM的诊断和管理至关重要.
研究的目的:
- 描述移植受体中DCM的诊断方法和临床结果.
- 在这个患者群体中确定负责DCM的真菌病原体的谱.
- 为改善免疫受损宿主中DCM的管理策略提供见解.
主要方法:
- 在12年内对20例移植患者的DCM进行了回顾性审查.
- 临床表现分析,真菌学检查,真菌培养和血清 (1-3) β-D-葡萄糖抗原 (BDG) 水平.
- 评估治疗方式,包括抗真菌疗法和手术干预.
主要成果:
- 病变主要是单一的,结节的,位于四肢上.
- 直接的真菌学检查和真菌培养非常积极,确定了13种不同的真菌物种.
- 血清BDG始终被检测到 (100%),局部区域扩展是常见的 (79%).
结论:
- 移植脏的接受者表现出导致DCMs的各种各样的真菌物种.
- 准确的真菌学文档对于指导适当的抗真菌治疗至关重要.
- 血清BDG阳性似乎是诊断和监测DCM的可靠指标.
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