经宏基因组二代测序诊断5例小克银汉霉菌感染及文献复习  

Five cases of Cunninghamella spp.infection diagnosed by metagenomic next-generation sequencing and literature review

作　　者：贾素珍 罗雨晴 陈怡[1] 俞康[1] JIA Suzhen;LUO Yuqing;CHEN Yi;YU Kang(Department of Hematology,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou,325015,China)

机构地区：[1]温州医科大学附属第一医院血液内科血液重点实验室,温州325015

出　　处：《中国真菌学杂志》2023年第6期528-533,共6页Chinese Journal of Mycology

基　　金：温州市级基础性科研项目(2021Y1659)。

摘　　要：报道5例恶性血液病患者治疗过程中并发真菌感染,由于疾病的特殊性无法进行侵袭性操作,经宏基因二代测序(metagenomic next-generation sequencing,mNGS)诊断小克银汉霉菌感染。5例患者均患恶性血液病,3例存在粒细胞缺乏,4例肺部感染主要表现为咳嗽、气促、呼吸费力等,1例颅内感染表现为发热、单侧肢体无力麻木。5例血培养均为阴性,通过mNGS检测确诊为小克银汉霉菌感染,调整为以两性霉素B为基础的联合治疗。1例感染得到控制,4例出现脏器衰竭、脑出血等并发症后放弃治疗。回顾分析2012年1月—2022年5月期间发表的34例血液病合并小克银汉霉感染案例。To report 5 patients with malignant hematological diseases complicated with fungal infection during the treatment.Due to the particularity of the disease,the invasive operation could not be carried out.These cases were diagnosed with Cunninghamella spp.infection by metagenomic next-generation sequencing(mNGS).All the 5 patients had hematological malignancies,3 patients had neutropenia,4 patients had pulmonary infection such as cough,shortness of breath and dyspnea,and 1 patient with intracranial infection showed fever,unilateral limb weakness and numbness.All the 5 cases were negative in blood culture and were confirmed to be infected by Cunninghamella spp.by mNGSand adjusted to amphotericin B-based combined therapy.Infection was controlled in 1 case,other 4 cases gave up treatment after complications such as organ failure and cerebral hemorrhage.Retrospective analysis of 34 cases of hematological disease complicated with Cunninghamella spp.infection published from January 2012 to May 2022 was performed.

关 键 词：小克银汉霉属 血液病 宏基因组二代测序技术 

分 类 号：R519.8[医药卫生—内科学] R446.5[医药卫生—临床医学]