|本期目录/Table of Contents|

[1]吴欣宇,韩玉惠,郑德泉,等.鞘内注射两性霉素B联合静脉滴注伏立康唑成功救治1例脑曲霉菌病患者[J].医学研究与战创伤救治(原医学研究生学报),2014,16(05):479-481.[doi:10.3969/j.issn.1672-271X.2014.05.010]
　WU Xin-yu,HAN Yu-hui,ZHENG De-quan,et al.Successful treatment of cerebral aspergillosis with intrathecal injection amphotericin B and intravenous voriconazole[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2014,16(05):479-481.[doi:10.3969/j.issn.1672-271X.2014.05.010]
点击复制

鞘内注射两性霉素B联合静脉滴注伏立康唑成功救治1例脑曲霉菌病患者()
分享到62.8K

《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第16卷
期数:
2014年05期
页码:
479-481
栏目:
出版日期:
2014-09-20

文章信息/Info

Title:
Successful treatment of cerebral aspergillosis with intrathecal injection amphotericin B and intravenous voriconazole
作者:
吴欣宇; 韩玉惠; 郑德泉; 曾友福; 董闽田; 卢武生
363000福建漳州，厦门大学附属东南医院神经内科
Author(s):
WU Xin-yu; HAN Yu-hui; ZHENG De-quan; ZENG You-fu; DONG Min-tian; LU Wu-sheng.
Department of Neurology,the Affiliated Southeast Hospital of Xiamen University,Zhangzhou,Fujian 363000,China
关键词:
鞘内注射; 两性霉素B; 伏立康唑; 脑曲霉菌病
Keywords:
intrathecal injection;  amphotericin B;  voriconazole;  cerebral aspergillosis
分类号:
R519
DOI:
10.3969/j.issn.1672-271X.2014.05.010
文献标志码:
A
摘要:
目的脑曲霉菌病的发病率日益增多，治疗药物有限，病死率很高。总结成功救治1例脑曲霉菌病患者的经验。方法 立体定向下行脑穿刺活检术，脑组织病理活检结果明确 诊断。治疗采用联合抗真菌治疗，伏立康唑0.2 g，2/d,静脉滴注，疗程70 d；间断小剂量鞘内注射两性霉素B，剂量0.1 mg，1/周。结果 复查头颅磁共振，与初起病时比较病变明 显吸收，临床症状好转。随访3年无复发。结论 小剂量两性霉素B鞘内注射联合静脉滴注伏立康唑治疗脑曲霉菌病有较好疗效，无明显不良反应。
Abstract:
Objective Cerebral aspergillosis is increasing with more immunocompromised hosts.At present,the treatment of cerebral aspergillosis is limited,which has a high mortality rate.We treated of a cerebral aspergillosis patient successfully,and provided the clinical reference.Methods We reported a case of a cerebral aspergillosis who was diagnosed by brain biopsy.We therapy with intravenous caspofungin by two 0.2 g dose/day for 70 days，and combined intermittent small doses of intrathecal injection of amphotericin B by dose of just 0.1 mg，1/week.Results A magnetic resonance imaging of the brain and a cranial CT scan were reviewed.Pathological changes were absorbed and clinical symptoms from the previous improved markedly.We reviewed follow-up of 3 years without recurrence.Conclusion Therapy with intravenous caspofungin and combined intermittent small doses of intrathecal injection of amphotericin B has a effect therapy,and which has a low side effect.

参考文献/References:

[1]Viscoli C,Machetti M,Gazzola P,et al.Aspergillus galactomannan antigen in the cerebrospinal fluid of bone marrow transplant recipients with probable cerebral aspergillosis［J］.J Clin Microbiol,2002,40(4):1496-1499.
[2］Kousha M,Tadi R,Soubani AO.Pulmonary aspergillosis:a clinical review［J］.Eur Respir Rev,2011,20(121):156-174.
[3］Pelaez T,Gijón P,Bunsow E,et al.Resistance to voriconazole due to a G448S substitution in Aspergillus fumigatus in a patient with cerebral aspergillosis ［J］.J Clin Microbiol,2012,50(7):2531-2534.
[4］Denning DW.Therapeutic outcome in invasive aspergillosis［J］.Clin Infect Dis,1996,23(3):608-615.
[5］Stevens DA,Kan VL,Judson MA,et al.Practice guidelines for diseases caused by Aspergillus.Infectious Diseases Society of America［J］.Clin Infect Dis,2000,30(4):696-709.
[6］Mai Ta M,Flowers SA,Rogers PD.The role of voriconazole in the treatment of central nervous system blastomycosis［J］.Ann Pharmacother,2009,43(10):1696- 1700.
[7］Abruzzo GK,Gill CJ,Flattery AM,et al.Efficacy of the echinocandin caspofungin against disseminated aspergillosis and candidiasis in cyclophosphamide- induced immunosuppressed mice［J］.Antimicrob Agents Chemother,2000,44(9):2310-2318.
[8］Caillot D,Bassaris H,McGeer A,et al.Intravenous itraconazole followed by oral itraconazole in the treatment of invasive pulmonary aspergillosis in patients with hematologic malignancies,chronic granulomatous disease,or AIDS［J］.Clin Infect Dis,2001,33(8):e83-e90.
[9］Chiller TM,Sobel RA,Luque JC,et al.Efficacy of amphotericin B or itraconazole in a murine model of central nervous system Aspergillus infection ［J］.Antimicrob Agents Chemother,2003,47(2):813-815.
[10］Herbrecht R,Denning DW,Patterson TF,et al.Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis［J］.N Engl J Med,2002,347 (6):408-415.
[11］Stiefel M,Reiss T,Staege MS,et al.Successful treatment with voriconazole of aspergillus brain abscess in a boy with medulloblastoma［J］.Pediatr Blood Cancer,2005,49(2):203-207.
[12］Henrya ME,Bolo NR,Zuo CS,et al.Quantification of brain voriconazole levels in healthy adults using fluorine magnetic resonance spectroscopy ［J］.Antimicrob Agents Chemother,2013,57(11):5271-5276.
[13］Schwartz S,Ruhnke M,Ribaud P,et al.Improved outcome in central nervous system aspergillosis,using voriconazole treatment［J］.Blood,2005,106(8):2641- 2645.
[14］Denning DW,Ribaud P,Milpied N,et al.Efficacy and safety of voriconazole in the treatment of acute invasive aspergillosis［J］.Clin Infect Dis,2002,34 (5):563-571.
[15］Clemons KV,Schwartz JA,Stevens DA.Experimental central nervous system aspergillosis therapy:efficacy,drug levels and localization,Immunohistopathology and toxicity［J］.Antimicrobial Agents Chemother,2012,56(8):4439-4449.

相似文献/References:

备注/Memo

备注/Memo:
-
更新日期/Last Update: 2014-09-20