构巢曲霉致肺曲霉病患者二例临床特征和病原学分析  

Clinical characteristics and etiological analysis on two cases with pulmonary aspergillosis caused by Aspergillus nidulans

作　　者：王育英[1] 曹敬荣[1] 兰贺[1] 赵越[1] 谢威[1] 王岩[1] 闵嵘[1] 王培昌[1] Wang Yuying;Cao Jingrong;Lan He;Zhao Yue;Xie Wei;Wang Yan;Min Rong;Wang Peichang(Department of Laboratory,Xuanwu Hospital of Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院检验科,北京100053

出　　处：《中华实验和临床感染病杂志（电子版）》2018年第4期413-416,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：首都医科大学校长基金(No.2016JYY96)

摘　　要：目的探讨构巢曲霉致肺曲霉病的临床及病原学特点。方法收集首都医科大学宣武医院2017年1月2例住院慢性阻塞性肺疾病患者的病例信息,分析患者的临床资料和实验室对病原菌的分离鉴定并复习相关文献。结果两例患者均有慢性阻塞性肺部疾病史及多种基础疾病,临床表现为发热、咳嗽、喘息等,胸部影像学显示肺部斑片状高密度影;实验室检测G试验和GM试验均为阳性;痰液直接涂片镜检可见隔菌丝,分支45°角,分离菌经质谱和测序分析确定为构巢曲霉。临床根据病原学结果改用伏立康唑治疗后患者症状及体征好转出院。结论构巢曲霉致肺曲霉病相对少见,病原学诊断对临床早期有效治疗肺曲霉病很重要。Objective To investigate the charicteristics of clinic and pathogen of pulmonary aspergillosis caused by Aspergillus nidulans. Methods Data of two hospitalized patients with chronic obstructive pulmonary disease in Xuanwu Hospital of Capital Medical University in January 2017 were collected. The clinical and laboratory data of the two cases were analyzed, respectively. The isolation and identification of pathogenic fungus were determined, and the literature was reviewed. Results Two patients both had a history of long-term chronic obstructive pulmonary disease and a variety of underlying diseases. Clinical manifestations were high fever, cough, wheezing and so on. Chest imaging showed that pulmonary patchy high-density shadow. The isolate was identified as Aspergillus nidulans by sequencing and matrix assisted laser desorption ionization time of flight mass spectrometry（MALDI-TOF MS）. Patients＇ symptoms and signs improved after treatment by voriconazole. Conclusions Pulmonary aspergillosis caused by Aspergillus nidulans is relatively rare, and etiological diagnosis is important to early effective treatment.

关 键 词：构巢曲霉 肺曲霉病 基质辅助激光解析电离飞行时间质谱 

分 类 号：R563.1[医药卫生—呼吸系统]