侵袭性肺曲菌病一例及文献复习  

Invasive Pulmonary Aspergillosis:A Case Report and Literature Review

作　　者：陈乐蓉[1] 张玉兰[1] 刘红莲[1] 

机构地区：[1]江西省胸科医院呼吸内科,南昌330006

出　　处：《实用临床医学（江西）》2006年第11期20-23,共4页Practical Clinical Medicine

摘　　要：目的:提高对侵袭性肺曲菌病(IPA)的临床、胸部影像学、诊断和治疗的认识。方法:结合有关文献对1例经电子支气管镜活检证实的IPA患者的临床资料进行分析。结果:胸片示:两肺野见片状、斑片状模糊影,其中可见透光区;电子支气管镜检查示:双侧支气管各叶段开口大量白色坏死物附着,以右下叶背段为主,黏膜充血水肿,未见出血及新生物;病理检查示:少量黏膜及坏死组织,周围见曲菌菌丝及孢子体,黏膜上皮显著增生。经治疗后,患者好转出院。结论:IPA是一种机会性感染的肺真菌病,无特异性的临床表现,影像学表现亦无特异性,支气管镜检查对IPA有诊断价值,IPA应早期治疗。Objective： To highlight the characteristics of invasive pulmonary aspergillosis （IPA）. Methods. The clinical data of a patient with IPA confirmed by electronic bronchoscope were presented,and relevant literature were reviewed. Results：Clinical presentation of the patient with IPA included fever,cough, and dyspnea. On chest radiography,it presents patchy and hole. Eleetron-bronchoscoyic finding showed that there was a lot of write necrospermic tissue and no blood and new growth in all of leaf, segment bronchi and bronchial mucosas were congested edema. Patho- logical changes took place mostly in the superior branch of the right inferior lobe;The pathological findings include a few mucosas and necrospermic tissue, hypha sporophyte of aspergillus and remarkably hyperplastic mucosal epithelium. The patient was mend and discharged afte the therapy with itraconazole and Amphotericin B et al. Conelusion. IPA is a pulmonary fungous disease of chance infection, and has no characteristic clinical manifestations. Radiographic findings are no characteristic too. Bronchoscope has important value to the diagnosis of IPA. IPA should be treated at early stage.

关 键 词：侵袭性肺曲菌病 病例报告 

分 类 号：R519.8[医药卫生—内科学]