以G试验阳性误诊为侵袭性真菌感染1例  

Misdiagnosis of invasive fungal infection due to positive G assay and liter- ature review

作　　者：殷莉[1] 饶进[1] 林志美[1] 

机构地区：[1]成都大学附属医院内分泌血液科,四川成都610081

出　　处：《中国现代医生》2013年第36期125-126,共2页China Modern Doctor

摘　　要：目的提高正确分析血浆(1,3)-β-D-葡聚糖检测(G试验)阳性的认识。方法报道1例因G试验阳性而被误诊为侵袭性真菌感染的多发性骨髓瘤患者,并结合文献复习。结果患者行VDT方案化疗,硫普罗宁保肝,期间出现高热,G试验阳性,予经验性抗真菌治疗,因严重副反应未完成。但停用硫普罗宁后,体温恢复正常,G试验正常。结论 G试验因其阳性预测值及特异性低,在诊断侵袭性真菌感染时存在局限性,应加深对G试验阳性的认识,避免过度治疗。Objective To recognize the importance of correctly analyzing the positive result of （1, 3）-β-D-glucan assay （G assay）. Methods One case of multiple myeloma was misdiagnosed as being complicated with invasive fungal infection due to positive G assay and literature review was combined. Results The patient with multiple myeloma was treated with VDT regimen and liver-protective Tiopronin, during which he got a high fever and the G assay was positive,Empirical antifungal-infective therapy was then implemented but discontinued because of severe adverse reaction. However in his repeated hospitalization, body temperature and the serum level of （1,3）-β-D-glucan returned to norreal each time Tiopronin was discontinued. Conclusion The G assay has limited usefulness because of its low positive predictive value and sPecificity in the diagnosis of invasive fungal infections. The correct judgment of G assay is essen- tial to make diagnosis and avoid excessive treatment.

关 键 词：(1 3)-β-D-葡聚糖 侵袭性真菌感染 误诊 

分 类 号：R519[医药卫生—内科学]