坎迪达内心炎:关于诊断和治疗的当前观点
Ronen Ben-Ami1, Matteo Bassetti2, Emilio Bouza3
1Infectious Diseases Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
概括
坎迪达感染性内心炎 (CIE) 是一种严重的疾病,死亡率和复发率很高. 早期的多学科护理和新的抗真菌策略对于改善患者的治疗结果和预防复发至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 心脏病学 心脏病学
- 菌类学 菌类学是指菌类学.
背景情况:
- 坎迪达感染性内心炎 (CIE) 是一种罕见但严重的疾病,死亡率高 (36-49%),复发率高.
- 由于间歇性阴性血液培养和当前标准的局限性,诊断具有挑战性.
- 最佳的诊断和治疗策略,包括成像和随访,需要进一步定义.
研究的目的:
- 审查CIE的诊断和管理.
- 专注于心脏成像,抗真菌疗法挑战,手术干预的影响和后续策略.
主要方法:
- 在PubMed中使用关键词进行全面的文献搜索:Candida内心炎,真菌生物标志物,心声学,抗真菌疗法,手术管理.
- 包括通过搜索和参考选识别的临床相关文章.
主要成果:
- 心声图是主要的诊断工具,但风险分层是探索性的.
- 像真菌生物标志物和PET/CT等新型诊断方法显示出希望,但缺乏可靠的数据.
- 多种模式的治疗包括长期的抗真菌疗法 (乙甘丁或脂质体安二B加上流动) 和手术;假体膜感染可能需要终身抑制治疗.
结论:
- 由于高死亡率和复发率,早期的多学科参与至关重要.
- 新兴的抗真菌耐药性需要研究抗菌膜策略和下一代抗真菌药物.
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