结核病和系统性真菌感染的临床和诊断误解
Karthikeyan Sundaram1, Sridhar Rathinam2, Venkataraman Prabhu3
1Department of Herbal Pharmacology and Environmental Sustainability, Chettinad hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Chennai, Tamil Nadu, India.
Journal de mycologie medicale
|February 4, 2026
概括
结核病和真菌感染表现出类似的症状,特别是在免疫受损的个体中. 区分这些疾病需要特定的测试,如Aspergillus特定的IgG血清学和CT成像,以准确诊断.
科学领域:
- 医学真菌学 医学真菌学
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
背景情况:
- 结核病 (TB) 和全身性真菌病是机会性感染.
- 免疫功能低下的个体,特别是携带人类免疫缺陷病毒 (PLHIV) 的人,往往会出现重叠的症状.
- 慢性肺性阿斯伯吉洛症 (CPA) 与肺结核 (PTB) 具有相同的临床特征,这对诊断提出了重大挑战.
研究的目的:
- 审查结核病和真菌感染的流行,临床表现和诊断挑战.
- 为了突出PTB和CPA之间的准确区分的重要性.
- 讨论模仿结核病的各种真菌感染的诊断工具.
主要方法:
- 文献综述分析流行,临床表现和诊断策略.
- 诊断方法的比较,包括血清学,GeneXpert和CT成像.
- 在CPA患者中讨论细胞因子 (Th2,IFN-γ) 概况.
主要成果:
- 在排除PTB后,通常考虑CPA诊断,但相反的情况不太常见.
- 在CPA中,纤维化和化会导致误诊.
- 针对阿斯伯吉勒斯菌的IgG血清学对于区分PTB/复发与CPA至关重要.
- 其他真菌感染 (粘菌菌,密码菌,细胞质菌,细胞质菌) 也模仿结核病症状.
- 放射分析不足以确定确定的诊断.
- 基因Xpert能够快速检测结核病和耐药性;CT成像对CPA和其他真菌感染更为优越.
结论:
- 精确区分结核病和真菌感染至关重要,特别是在免疫功能低下的患者中.
- 需要特定的诊断工具来避免误诊,并确保适当的治疗.
- CT成像和Aspergillus特异性IgG血清学在诊断CPA和区分它与PTB方面发挥着关键作用.
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