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NEJM:念珠菌性食管炎-案例报道

2017-04-20 xing.T MedSci原创

人类免疫缺陷病毒血清学试验为阴性,念珠菌性食管炎是免疫低下宿主常见的机会性感染。长期使用抗生素治疗可成为免疫功能正常患者的危险因素。

患者为一名72岁的男性,因吞咽疼痛2周而就诊。这种症状在就诊16个月有过发作,患者被诊断为弥漫性泛细支气管炎,自那以后该患者一直在接受长期治疗的大环内酯类抗生素治疗。他没有接受过糖皮质激素或其他免疫抑制剂治疗。

消化道内镜检查显示,食管呈线形、白色、粘膜、斑块状病变(如图A所示)。无口咽部或胃十二指肠病变。该患者在特征性内镜检查结果的基础上并通过食管刷标本培养得到白色念珠菌阳性结果,被诊断为念珠菌食管炎。



人类免疫缺陷病毒血清学试验为阴性,念珠菌性食管炎是免疫低下宿主常见的机会性感染。长期使用抗生素治疗可成为免疫功能正常患者的危险因素。

患者开始口服抗真菌治疗,开始治疗后2周内,患者吞咽疼痛减轻。在抗真菌治疗开始后12周再次进行内镜检查,发现食管病变的数目和严重程度明显减少(如图B所示)。

原始出处:


Takeshi Kondo,et al. Candida Esophagitis.N Engl J Med 2017; http://www.nejm.org/doi/full/10.1056/NEJMicm1614893

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    2017-04-29 cuiyejia

    学习了,谢谢分享

    0

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    2017-04-21 小康子70

    念珠菌引起的大多是机会性感染

    0

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    2017-04-21 zhouqu_8
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    2017-04-20 virya

    念珠菌性食管炎是免疫低下宿主常见的机会性感染。长期使用抗生素治疗可成为免疫功能正常患者的危险因素。合理使用抗生素太太重要啦

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