微生物与感染
2025年1月8日 星期三   首页 |  主编心语 |  期刊介绍 |  编委阵容 |  投稿指南 |  出版道德 |  期刊订阅 |  联系我们 | English
微生物与感染
  论著 本期目录 | 过刊浏览 | 高级检索 |
55例社区获得性肺隐球菌病病例分析
王琴; 刘莉; 范碧君; 李华茵; 白春学; 宋元林; 何礼贤
复旦大学附属中山医院呼吸内科,上海 200032
A clinical analysis of 55 cases of community-acquired pulmonary cryptococcosis
WANG Qin; LIU Li; FAN Bi-Jun; LI Hua-Yin; BAI Chun-Xue; SONG Yuan-Lin; HE Li-Xian
Department of Respiratory,Zhongshan Hospital,Fudan University,Shanghai 200032,China
全文: PDF (587 KB)   HTML (0)
输出: BibTeX | EndNote (RIS)      
摘要: 本文旨在通过研究社区获得性肺隐球菌病的临床特点,提高医务人员对肺隐球菌病的认识,做到早期诊断和治疗。采用回顾性病例分析研究,统计2003 年1 月~2009 年12 月入住复旦大学附属中山医院的 55例确诊及临床诊断为肺隐球菌病患者的临床资料。55 例患者中,男性34 例,女性21 例;年龄17~75 岁,平均(44.8 ± 13.4) 岁。69.1 %无明显基础疾病。38.2% 无症状,因体检发现肺部阴影而就诊。6 1. 8% 有以下症状:咳嗽、咳痰,胸闷,发热,胸痛;症状轻,体征不明显,偶有肺部湿眼音。影像学表现:53.0% 表现为单发和 (或)多发结节肿块影, 3 1. 4% 表现为渗出实变影, 15.7% 为混合病灶。实验室检查:25 例患者行隐球菌乳胶凝集试验检查,阳性率100% 。痰真菌培养、活检组织培养和气管镜吸出物培养分别见新生隐球菌1 例、41 例和2 例。组织病理学检查:主要表现为肉芽肿性病变,多核巨细胞内、外见隐球菌孢子;过腆酸-雪夫染色细胞壁呈红色,阳性率为88. 5 % ; Grocott 六胺银染色细胞壁呈银黑色,阳性率为88.5% 。结果提示,社区获得性肺隐球菌病多见于中年男性,临床症状轻微,影像学表现多样,病理学及相应病原学、血清学检查有较高的诊断价值。

服务
把本文推荐给朋友
加入我的书架
加入引用管理器
E-mail Alert
RSS
作者相关文章
王琴
李华茵
白春学
宋元林
何礼贤
关键词 肺隐球菌病新生隐球菌诊断    
Abstract:To investigate the clinical characteristics of community-acquired pulmonary cryptococcosis, a total of 55 cases of pulmonary cryptococcosis diagnosed at Zhongshan Hospital, Fudan University from 2003 to 2009 were retrospectively analyzed. The patients were consisted of 34 males and 21 females , with median age of 44.8±13.4 (17 to 75) years , 69.1 % of whom had no underlying diseases. Among those patients, 38.2% were asymptomatic, and 61. 8% had respiratory and (or) constitutional symptoms. The common symptoms were cough/ expectoration, fever , chest pain , and dyspnea on exertion. The common computed tomography (CT) scan patterns were nodule and mass, either solitary or multiple (53.0%) , infiltration and consolidation (31. 4 %), or diffused and mixed lesions (15. 7%). Twenty-five patients underwent latex agglutination test for pulmonary cryptococcosis, and 100% were positive. Cryptococcus neoformans was found in four biopsy tissue smears, in one sputum culture , and in two bronchoscopic lavage fluid cultures Non-caseous granuloma was the main characteristic in pathological study, with multinucleated giant cells containing abundant vacuolus yeast forms shown by periodic acid-Schiff (PAS) reaction and/ or GrocottGomori' s methenamine silver (GMS) staining. In conclusion, community-acquired pulmonary cryptococcosis is more prevalent in middle-aged male patients, the symptoms are mild, and the imaging patterns are multiple. Pathological, etiological, and serological examinations are valuable diagnostic tools.

Key wordsPulmonary cryptococcosis    Cryptococcus neoformans    Diagnosis
通讯作者: 李华茵   
引用本文:   
王琴; 刘莉; 范碧君; 李华茵; 白春学; 宋元林; 何礼贤. 55例社区获得性肺隐球菌病病例分析[J]. 微生物与感染 , 2011, 6(3): 144-148.
WANG Qin; LIU Li; FAN Bi-Jun; LI Hua-Yin; BAI Chun-Xue; SONG Yuan-Lin; HE Li-Xian. A clinical analysis of 55 cases of community-acquired pulmonary cryptococcosis. Journal of Microbes and Infections, 2011, 6(3): 144-148.
链接本文:  
http://jmi.fudan.edu.cn/CN/      或     http://jmi.fudan.edu.cn/CN/Y2011/V6/I3/144

版权所有 © 2008 《微生物与感染》编辑部
地址:上海市医学院路138号 邮编:200032
Tel:021-54237633 Fax:021-64434224    E-mail:jmi@fudan.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发  技术支持:support@magtech.com.cn