热带病与寄生虫学

热带病与寄生虫学 ›› 2014, Vol. 12 ›› Issue (2): 75-77,105.doi: 10.3969/j.issn.1672-2302.2014.02.005

• 论著 • 上一篇    下一篇

48 例真菌所致社区获得性肺炎病例分析

酆孟洁,王凌伟,史菲,邱晨   

  1. 518000 广东深圳市，暨南大学第二临床医学院深圳市人民医院呼吸内科
  • 出版日期:2014-06-10 发布日期:2014-08-13
  • 基金资助:

    2011 年广东省深圳市科技计划项目立项(201102152)

A clinical analysis of 48 cases of community-acquired pulmonary mycosis

Feng Mengjie, Wang Linwei,Shi Fei, Qiu Chen.   

  1. Department of respiratory Diseases, Shenzhen People's Hospotal, The Second Clinical Medical College of Jinan University, Shenzhen 518020, China.
  • Online:2014-06-10 Published:2014-08-13

摘要： 目的 总结真菌所致社区获得性肺炎（CAP）患者的临床特点。方法 回顾性研究近十年48例在我院确诊为真菌感染所致CAP 患者的临床资料。结果 48 例患者中，男性34 例，女性14 例；年龄18~75 岁，平均(42.94±13.52)岁。41.67%的患者无明显基础疾病。22.92%的患者临床无症状，因体检发现肺部阴影而就诊。77.08%的患者有以下症状：咳嗽和(或)咳痰、咯血、发热、气促等。影像学表现：72.92%的患者表现为单发和(或)多发结节肿块影，50%的患者表现为渗出斑片影和（或）实变影。纤支镜粘膜活检、经皮肺穿刺活检和胸腔镜楔形切除术/肺叶切除术有助于获取有价值的肺组织标本。确诊依赖于标本的形态学观察和真菌培养。结论 真菌感染所致CAP 多见于中年男性，临床症状轻微，影像学表现多样。多部位、多次肺活检有助于明确诊断。

关键词: 社区获得性肺炎, 真菌病, 曲霉菌, 新生隐球菌

Abstract:

Objective To investigate the clinical characteristics of community- acquircd pulmonary mycosis. Methods A total of 48 cases of pulmonary mycosis diagnosed at Shenzhen People's Hospotal from 2003 to 2013 were retrospectively analyzed． Results The patients were consisted of 34 males and 14 females，with median age of 42.94 ± 13.52 (18 to 75 ) years，41.67% of whom had no underlying diseases．Among those patients，22.92% were asymptomatic，and 77.08% had respiratory and (or) constitutional symptoms symptoms．The common symptoms were cough / expectoration, hemoptysis，fever, chest pain, and dyspnea on exertion. The common computed tomography (CT) scan patterns were nodule and mass，either solitary or multiple(72.92% )，infiltration and（or）consolidation(50% )。transbronchoscopic lung biopsy, CT guided lung puncture/biopsy , thoracoscopic wedge resection and thoracoscopy- assisted mini- lobectomy
are effective and valuable techniques for evaluating undetermined pulmonary lesions. definite diagnosis is based on Morphological observation and fungal culture. Conclusion community- acquired pulmonary mycosisis is more prevalent in middle-aged male patients. The symptoms are mild，and the imagine patterns
are multiple. Repeated multiple biopsies are essential to confirm the diagnosis.

Key words: community-acquired pneumonia, mycosis, aspergillosis, cryptococcosis