摘要
目的总结分析真菌性感染性心内膜炎(FE)病例的临床特点,为临床合理诊治提供依据。方法收集华西医院2008年1月至2015年8月住院的符合Duke标准且培养阳性的7例FE患者,分析其临床表现、微生物学特征、治疗方式及预后。结果 7例FE患者中男性5例,女性2例,2例(28.57%)存在人工心脏瓣膜,2例(28.57%)患者既往有瓣膜性心脏病,2例患者存在心脏留置装置。7例患者经胸超声心动图检查均发现赘生物。6例(85.71%)为念珠菌感染,其中近平滑念珠菌3例,白色念珠菌、光滑念珠菌、热带念珠菌各1例,另1例为烟曲霉菌感染。3例经单纯内科抗真菌治疗,4例内科联合外科手术治疗。6例患者至少出现一种并发症,2例患者住院期间死亡。结论 FE临床表现无特异性,在医疗保健相关性患者中多见,病原菌中非白念珠菌比例上升,栓塞事件发生率高,住院病死率较高。
Objective To explore the clinical characteristics,treatment regimens and outcomes of the patients with fungalendocarditis（FE）.Methods An observational study was conducted at our hospital from Jan.2008 to Aug.2015,andrecruited 7 patients of FE with Duke criteria and positive culture.Their clinical manifestation,microbiologicalcharacteristics,treatment and outcomes were analyzed.Results There were 5 males and 2 females in 7 FE patients,prosthetic heart valves were present in 2 patients（28.57%）,valvular heart disease was present in 2 patients（28.57%）,and cardiac indwelling devices were present in 2 patients.Transvaginal echocardiography was found in all seven patients.Sixcases（85.71%）were Candida infections,including 3 cases of Candida parapsilosis,1 case of Candida albicans,Candida glabrata,and Candida tropicalis;1 case of Aspergillus fumigatus infection.Three cases were treated with antibiotics aloneand four cases were treated with internal medicine and surgery.Six patients had at least one complication.Two patients diedduring hospitalization.Conclusion The clinical manifestations of FE are not specific,and are more common in health care-related patients.Among the pathogens,the proportion of non-Candida albicans pathogens increased.The incidence ofembolism events and hospital mortality were high.
作者
唐光敏
邓蓉
周冠宇
刘真真
TANG Guang-min;DENG Rong;ZHOU Guan-yu;LIU Zhen-zhen(Center oflnfectious Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China)
出处
《热带医学杂志》
CAS
2018年第6期759-760,765,共3页
Journal of Tropical Medicine
基金
四川省科技厅计划项目(2014KJT026-2014SZ)
