患有血液性恶性瘤的患者的真菌相关肺炎
Sarai Pineda-Benítez1, Beda D Islas-Muñoz1, Pamela Alatorre-Fernández1
1Infectious Diseases Department, Instituto Nacional de Cancerología (INCan), Av. San Fernando No. 22, Col. Sección XVI, Del. Tlalpan, 14000, Mexico City, Mexico.
Indian journal of medical microbiology
|June 26, 2024
概括
血液性恶性瘤患者面临侵袭性肺部真菌感染的高风险. 通过CT扫描和银河的早期诊断,以及适当的抗真菌治疗,可以提高生存率.
科学领域:
- 在瘤学瘤学.
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
背景情况:
- 患有血液性恶性瘤 (HM) 的患者特别容易受到侵袭性肺部真菌感染 (ILFI) 的影响.
- 真菌性肺炎构成重大威胁,需要对其特征和这一群体的结果有更深入的了解.
研究的目的:
- 描述HM和真菌性肺炎的成年患者在五年期间的临床特征,治疗策略和结果.
- 为了确定与诊断出真菌性肺炎的HM患者的死亡率相关的因素.
主要方法:
- 在墨西哥城的一家三级医疗瘤医院进行了一项回顾性研究.
- 包括210名患有HM和真菌性肺炎的成年患者 (根据EORTC/MSG标准2021的证明,可能或可能) 从2017年1月到2022年12月.
- 收集的数据包括人口统计数据,HM类型,中性质衰竭的持续时间,CT胸部发现,真菌标记 (血清银曼南,支气管支气管洗) 和接受的治疗.
主要成果:
- 最常见的HM是急性淋巴细胞白血病 (35.2%) 和急性髓性白血病 (32.4%).
- 在66.7%的患者中存在严重的中性质减退 (中位数为16天). CT胸部扫描经常显示多个结节 (62.9%).
- 在30天内死亡率为25.2%. 与早期死亡相关的因素包括低albuminemia,休克,可能的ILFI和不适当的抗真菌治疗.
结论:
- 脑电图胸部扫描和血清银河曼南是诊断高风险HM患者ILFI的宝贵工具.
- 及时和适当的抗真菌治疗对于改善这一脆弱群体的生存结果至关重要.
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