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Fusarium infection: Report of 26 cases and review of 97 cases from the literature

机译:镰刀菌感染26例报告并文献复习97例

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摘要

Fusarium species is a ubiquitous fungus that causes opportunistic infections. We present 26 cases of invasive fusariosis categorized according to the European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) criteria of fungal infections. All cases (20 proven and 6 probable) were treated from January 2000 until January 2010. We also review 97 cases reported since 2000. The most important risk factors for invasive fusariosis in our patients were compromised immune system, specifically lung transplantation (n = 6) and hematologic malignancies (n = 5), and burns (n = 7 patients with skin fusariosis), while the most commonly infected site was the skin in 11 of 26 patients. The mortality rates among our patients with disseminated, skin, and pulmonary fusariosis were 50%, 40%, and 37.5%, respectively. Fusarium solani was the most frequent species, isolated from 49% of literature cases. Blood cultures were positive in 82% of both current study and literature patients with disseminated fusariosis, while the remaining 16% had 2 noncontiguous sites of infection but negative blood cultures. Surgical removal of focal lesions was effective in both current study and literature cases.Skin lesions in immunocompromised patients should raise the suspicion for skin or disseminated fusariosis. The combination of medical monotherapy with voriconazole or amphotericin B and surgery in such cases is highly suggested.
机译:镰刀菌属物种是导致机会性感染的普遍存在的真菌。我们根据欧洲真菌感染研究与治疗组织(EORTC / MSG)真菌感染标准对26例侵袭性融合病进行了分类。从2000年1月至2010年1月,所有病例(已确诊20例,可能6例)均得到治疗。我们还回顾了2000年以来报告的97例。我们患者中侵袭性融合症的最重要危险因素是免疫系统受损,特别是肺移植(n = 6)。 ),血液系统恶性肿瘤(n = 5)和烧伤(n = 7名皮肤融合症患者),而最常见的感染部位是26名患者中的11名皮肤。在我们的弥散性,皮肤性和肺部融合病患者中,死亡率分别为50%,40%和37.5%。茄枯萎菌是最常见的物种,从49%的文献病例中分离出来。在目前的研究和文献报道的散发性肺炎病患者中,有82%的血培养呈阳性,而其余16%的患者有2个不连续的感染部位,但血培养为阴性。手术切除局灶性病变在当前研究和文献报道中均有效。免疫功能低下患者的皮肤病变应引起对皮肤或弥漫性镰刀菌病的怀疑。在这种情况下,强烈建议将伏立康唑或两性霉素B的药物单一疗法与手术相结合。

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