烟曲霉播散性感染1例误诊分析  

A misdiagnosed case of invasive aspergillosis

作　　者：郭凯[1] 项珍珍[2] 桑军军 陈莉[1] 

机构地区：[1]第二军医大学附属长海医院血液科,上海200433 [2]第二军医大学附属长海医院病理科,上海200433 [3]南京军区福州总医院皮肤科,福州350000

出　　处：《中国真菌学杂志》2016年第6期372-375,共4页Chinese Journal of Mycology

基　　金：上海市自然科学基金(15ZR1412600);国家973项目(2013CB531601);上海市医学真菌分子生物学重点实验室开放课题基金(14DZ2272900)

摘　　要：报道1例由烟曲霉导致的全身侵袭性真菌感染。患者男,32岁,因腹主动脉瘤及腹部肿块入我院血管外科行腹主动脉成型及夹层动脉瘤腔内栓塞术,术中腹部包块冰冻病理提示巨大淋巴结增生症(Castleman病)转入我科进一步治疗。PET-CT提示恶性淋巴瘤,考虑为恶性肿瘤,但骨髓穿刺及细胞免疫表型流式未见明显异常,淋巴结及腹部包块病理回报提示真菌感染,给予米卡芬净等抗真菌治疗,患者因感染严重全身器官衰竭死亡,后病理组织提取真菌DNA经ITS测序后确诊为烟曲霉感染。We reported a case of invasive aspergillosis.A male patient,32 years old,had undergone an endovascular repair of abdominal aortic aneurysm in department of vascular surgery.The result of intraoperative frozen pathology of abdominal mass revealed Castleman＇s disease. For further treatment, the patient transferred to our department. PET-CT revealed malignant lymphoma.Examination of bone marrow aspirate showed no abnormal sign. Histopathological findings revealed features of fungal infection in lymph nodes and abdominal mass.Despite Micafungin therapy, the patients died of multiorgan failure.We extracted fungal DNA from fungal pathology.ITS sequencing confirmed the fungus as Aspergillus fumigatus.

关 键 词：侵袭性真菌感染 烟曲霉 误诊 

分 类 号：R519.8[医药卫生—内科学]