气道支气管曲霉病1例报告及文献复习

Tracheobronchial aspergillosis:one case report and literature review

目的了解气道侵袭性曲霉病的临床特征、诊断和治疗。方法对1例气道侵袭性曲霉病患者的临床表现、纤维支气管镜检查和病理诊断进行分析并作文献复习。结果1例患者临床表现为咳嗽,胸闷,气急。纤维支气管镜下表现为新生物突出于管腔,病理示大量曲霉菌丝浸润至气道黏膜基层,伊曲康唑治疗24周后痊愈。结论气道侵袭性曲霉病以曲霉浸润到气道黏膜的基底层为特征,纤维支气管镜检查是有效的诊断手段,伊曲康唑是治疗气道侵袭性曲霉病的有效药物之一。

Objective To explore the clinical manifestations, diagnosis and treatment of airway invasive aspergillosis. Methods The clinical manifestations, bronchoscopy biopsy and histological analysis of one case of airway invasive aspergillosis were reviewed. Results The clinical manifestations included productive cough, hemoptysis and dyspnea. A big neoformation was protruding into the lumen under fibreoptic bronchoscope. Pathologic examination found Aspergillus species invading through bronchial wall. The patient was cured after treatment with itraconazole for 24 weeks. Conclusions The airway invasive aspergillosis is characterized by the presence of Aspergillus organisms invading to the airway basement membrane. Bronchoscopy is very important for accurate diagnosis. Itraconazole is one of the efficacious and safe agents in the treatment of airway invasive aspergillosis.