概括
皮质类固醇治疗可能会导致患者的散布性细胞质异位症 (DH),呈现持续发烧. 早期诊断和治疗对于改善这些免疫受损个体的结果至关重要.
科学领域:
- 医学真菌学 医学真菌学
- 传染性疾病 传染性疾病
- 免疫受损宿主研究
背景情况:
- 血清囊体通常不被认为是机会主义的.
- 皮质类固醇的使用可以改变免疫反应,可能增加对感染的易感性.
研究的目的:
- 为了调查在接受皮质类固醇治疗的患者中传播性基因质瘤 (DH) 的发生情况.
- 在这个患者群体中确定DH的临床和病理特征.
- 评估诊断方法及其对预后的影响.
主要方法:
- 五名经过皮质类固醇治疗,患有散布性细胞质的患者的回顾性病例系列分析.
- 对临床表现,诊断结果 (包括骨髓培养) 和病理特征的审查.
- 诊断延迟与患者结果的相关性.
主要成果:
- 在接受皮质类固醇治疗的5名患者中,发生了传播性基因质.
- 持续的,无法解释的发烧是主要症状.
- 病理发现包括巨细胞内的众多酵母形式,缺席的颗粒瘤和最小的炎症.
- 骨髓培养被确定为最佳的诊断研究.
- 延迟诊断与不良预后有关,有4例死亡直接归因于DH.
结论:
- 皮质类固醇治疗可能会使患者易患散布性基因质等离子体.
- 免疫抑制患者,特别是那些接受皮质类固醇治疗的患者,有不明原因的发烧,应评估是否感染了Histoplasma capsulatum.
- 及时诊断和干预对于在免疫功能受损的宿主中管理散布性细胞质瘤至关重要.
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