毛霉菌致持续性非卧床腹膜透析患者腹膜炎的临床分析  

Clinical analysis of mucormycosis peritonitis in a CAPD patient

作　　者：吴韵[1] 李新华[1] 宋亚香[1] 仓艳琴[1] 朱开元[1] 彭艾[1] 

机构地区：[1]同济大学附属第十人民医院肾脏免疫科,上海200072

出　　处：《同济大学学报（医学版）》2008年第6期131-133,共3页Journal of Tongji University(Medical Science)

基　　金：上海市自然科学基金项目(06ZR14161)

摘　　要：目的分析持续性非卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)患者感染毛霉菌性腹膜炎的临床特点。方法分析临床诊断毛霉菌性腹膜炎的CAPD患者1例并进行系统文献复习。结果男性患者73岁,有腹痛及持续性发热症状,体检脐周有压痛,腹透液检查示中性粒细胞升高,腹透液培养出须藓毛藓菌。大扶康治疗效果欠佳,后经卡泊芬静、终止腹膜透析、改为血液透析等治疗后患者体温恢复正常,腹痛消失。结论毛霉菌性腹膜炎与其他霉菌性腹膜炎临床表现相似,诊断及鉴别诊断易混淆;拔除腹透管是CAPD患者霉菌性腹膜炎好转的必要条件。Objective To study the clinical characteristics of mucormycosis peritonitis in a continuous ambulatory peritoneal dialysis （CAPD） patient. Methods One case of mucormycosis peritonitis with CAPD was diagnosed and related literature was reviewed. Results Abdominal pains and fever were found in a 73- year man. Pressing abdominal pains was found in the peri-umbilical region. Mucormycosis leukocytosis cultured and was identified in peritoneal dialysis solution. No effect of Azoles was observed in treating mucormycosis peritonitis patient, while Caspofungin was able to improve the abdominal pains and fever with the help of the dialysis extubation and hemodialysis. Conclusion The clinical characteristics of mucormycosis peritonitis are not different from the other fungal peritonitis. It is uneasy to diagnose and differentiate the mucormycosis peritonitis. Dialysis extubation is necessary for treating the fungal peritonitis.

关 键 词：毛霉菌 毛霉菌病 霉菌性腹膜炎 毛霉菌性腹膜炎 

分 类 号：R656.4[医药卫生—外科学]