小儿侵袭性真菌感染的诊治

Diagnosis and Treatment for Invasive Fungal Infection in Children

近年来侵袭性真菌感染(IFI)显著增多,患病率和病死率居高不下,IFI的病原菌主要由念珠菌属、曲霉菌、隐球菌属等机会致病真菌。由于IFI的临床表现无特异性,而真菌感染常发生在有严重基础疾病的患儿,其临床表现及组织病理反应与其他许多疾病相似,很难诊断,因而要结合实验室、影像、临床表现作出诊断。目前IFI的治疗策略分为预防性治疗、先发治疗、经验治疗和目标治疗,药物选择主要有咪唑类如氟康唑、伊曲康唑、伏立康唑等,多烯类如两性霉素B(脂质体)和卡泊芬净等。

The number of Invasive Fungus Infection（IFI） is increasing rapidly in recent years. The prevalence rate and mortality rate of IFI stay at a high level and the pathogenic bacteria of IFI mainly consist of many opportunistic pathomycete, such as Candida, Aspergillus and Cryptococeus. The clinical manifestation of IFI is non-specific ,furthermore, fungus infection often occurred in children with severe underlying diseases. Because its clinical manifestation and tissue pathological reaction is very similar to many other diseases, it is difficult to diagnosis and its diagnosis should depend on laboratory examination,imaging and clinical manifestation. At present, the therapeutic strategy is divided into prophylactic treatment, preemptive therapy, experimental therapy, objective therapy. The anti-fungal drugs mainly include imidazole such as fluconazole, itraconazole, voriconazole and so on as well as polyene such as amphotericin B （liposome）, caspefungin and so on.