与免疫力低下患者相关的曲霉菌肺部真菌感染:CT 扫描如何帮助诊断

Kristina Paskalita Kero, Dini Rachma Erawati
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摘要

免疫功能正常和免疫功能低下的患者都可能感染肺部真菌。曲霉属真菌很少见于人类。这些真菌可引起一系列疾病,尤其是免疫功能低下的患者,并具有重要的临床意义。我们要介绍的是一名 5 年前被诊断患有系统性红斑狼疮的 24 岁男性患者,他在住院治疗前 5 天主诉发烧,原因是肺炎。CT 扫描显示患者肺部有合并症和多发性结节,与肺部真菌感染相符。痰培养结果显示为卷曲菌。胸片显示双肺中下叶有浸润和合并症。早期和第二次 CT 扫描结果显示,围绕多个不规则结节(光晕征)的磨玻璃不透明、空洞性结节和反向光晕征。随后,患者的痰培养结果显示有卷曲菌属真菌生长。随后,患者接受了氟康唑和伏立康唑的真菌治疗。随访的胸部 CT 扫描显示,真菌治疗后病灶已消失。CT扫描检查、临床情况和微生物培养有助于诊断免疫力低下患者的弧菌肺部真菌感染。 关键词: Phaeohyphomycosis; Curvularia; Halo sign; Reverse halo sign
本文章由计算机程序翻译,如有差异,请以英文原文为准。
CURVULARIA PULMONARY FUNGAL INFECTION ASSOCIATED WITH IMMUNOCOMPROMISED PATIENT: HOW CT SCAN COULD HELP IN MAKING DIAGNOSIS
Pulmonary fungal infections can be found in immunocompetent and immunocompromised patients. The Curvularia species of fungi are rarely seen in humans. These fungi can be clinically significant and cause a range of disease processes, particularly in immunocompromised patients. We present a 24-year-old male patient diagnosed with SLE 5 years ago, complaining of fever five days before hospital administration concerning pneumonia. A CT scan revealed consolidation and multiple lung nodules compatible with a fungal pulmonary infection. The result of the sputum culture indicated Curvularia. A chest radiograph showed infiltrates with consolidation in the middle-lower lobes of both lungs. Early and second CT-scan findings revealed ground-glass opacity surrounding multiple irregular nodules (halo signs), cavitary nodules, and reverse halo signs. Afterward, the result of the patient’s sputum culture demonstrated fungal growth of the Curvularia species. The patient then underwent fungal treatment with fluconazole and voriconazole. The patient showed improvements, and a follow-up chest CT scan revealed the resolution of the lesion after fungal treatment. CT-scan examination, clinical condition, and microbiology culture can help diagnose Curvularia pulmonary fungal infection in immunocompromised patients.   Keyword: Phaeohyphomycosis; Curvularia; Halo sign; Reverse halo sign
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