文献类型：期刊文献

中文题名：肺隐球菌病12例临床分析

英文题名：Clinical analysis of 12 cases of pulmonary cryptococcosis

作者：阮永春[1];张春意[1];王伟[2]

机构：[1]绍兴市人民医院(绍兴文理学院附属第一医院)呼吸内科;[2]绍兴市人民医院(绍兴文理学院附属第一医院)病理科

年份：2011

卷号：23

期号：2

起止页码：166

中文期刊名：中国微生态学杂志

外文期刊名：Chinese Journal of Microecology

收录：CSTPCD、、CSCD_E2011_2012、CSCD

语种：中文

中文关键词：隐球菌病;肺隐球菌病;诊断;治疗

外文关键词：Cryptococcosis; Pulmonary cryptococcosis; Diagnosis; Therapy

中文摘要：目的提高对隐球菌病的认识。方法对确诊为肺隐球菌病的12例病例的临床资料进行回顾性分析。结果 12例病例中,男性8例,女性4例,年龄31~68岁,平均年龄（51.8±12.6）岁,6例伴有基础疾病,但无1例有鸟类接触史;有临床症状者10例,其中咳嗽8例,咯痰3例,胸痛4例,发热2例,有体征者仅2例;胸部影像表现为：12例病例均有病灶分布于肺外带或胸膜下,有10例下叶受累;结节或肿块性病变10例,肺实质浸润性病变1例,弥漫混合性病变1例,合并支气管充气征3例,合并空洞2例;组织病理学检查示在肉芽肿性炎中找到球形孢子;5例病例行肺叶切除术,术后应用氟康唑口服治疗,7例采用氟康唑或伊曲康唑口服治疗;其中3例失访,7例治愈,2例好转。结论肺隐球菌病可发生在免疫功能正常人群,与鸟类接触史关系不大;临床表现无特异性,影像学改变以结节或肿块性病变为主;诊断需结合病史、临床表现和胸部影像表现及相关实验室检查,确诊有赖于组织病理学检查;治疗主要是氟康唑等抗真菌药物,药物治疗效果差者可手术。

外文摘要：Objective To improve the understanding of pulmonary cryptococcosis.Method Retrospective analysis was performed on the clinical features of 12 pulmonary cryptococcosis cases.Result A total of 12 patients were diagnosed,8 males and 4 females with an average age of（51.8±12.6）years old（ranged from 31 to 68 years）.Six patients had underlying diseases,but no one had a history of close contact with birds.Ten patients had symptoms and 2 patients had signs.The main symptoms were cough（8 cases）,expectoration（3 cases）,chest pain（4 cases）,and pyrexia（2 cases）.Chest imaging findings：All the 12 cases had lesions located in the peripheral or subpleural,and the lesions were in the lower lobes in 10 cases.Radiologic manifestations showed multiform lesion such as nodules or masses in 10 cases,lobar consolidation in 1 case,and diffuse mixed pattern in 1 case;There were 3 cases complicated with air bronchogram,and 2 cases with cavity.Histopathological examination showed spherical spores in granulomatous inflammation.As to the treatment,5 patients underwent lobectomy and were given antifungal medicine such as fluconazole after operation,and the other 7 cases received antifungal medication of fluconazole or itraconazole only.Seven cases were fully cured,2 cases were improved,and 3 cases were lost to follow-up.Conclusion Pulmonary cryptococcosis can be seen among the immunocompetent people,and has little relation to history of contact with birds.It has no specific clinical manifestation,and pulmonary nodular or mass-type are the most common imaging findings.Diagnosis requires a combination of past history,clinical manifestations,chest imaging findings and related laboratory examinations,and confirmed diagnosis is according to histopathological examination.To treat the diseases,most of patients need antifungal drug application such as fluconazole,and surgery should be considered for persistent radiographic abnormalities and symptoms not responding to antifungal therapy.