气道侵袭性曲霉病1例并文献复习

Airway invasive aspergillosis：one case report and review of literature

目的探讨气道侵袭性曲霉病临床表现、诊断及治疗方法。方法结合我院收治的1例气道侵袭性曲霉病病例的临床资料及国内外文献报道进行综合分析。结果患者女性，49岁，间断咳嗽、咯痰、发热1个月，胸部CT提示左下叶实变，在外院抗炎、抗结核治疗1个月，未见明显好转收入院。入院后行气管镜检查，活检提示曲霉菌感染，抗真菌及气管镜下反复高频电凝治疗后，患者症状明显好转。结论气道侵袭性曲霉病较少见，曲霉在气道管腔内呈团块状生长，导致支气管阻塞、扩张，病情进展快，侵袭性强，早期、足疗程抗真菌治疗同时气管镜介入局部高频电凝治疗，可取得满意的疗效。

Objective To investigate the clinical manifestations, diagnosis and treatment of airway invasive aspergillosis. Methods The clinical data of one case of airway invasive aspergillosis in our hospital was reported and the related literatures were reviewed and analyzed. Results A 49-year-old female patient complained of intermittent cough, sputum and fever for one month. Chest computer tomography showed consolidation tips of left lung lower lobe. After anti-inflammatory, anti-tuberculosis treatment for one month in other hospital, the patient had no significant improvement in symptoms. In our hospital, the patient received bronchoscopic examination and the result was aspergillus infection in biopsy tips. After anti-fungal therapy and repeated tracheal endoscopic high-frequency coagulation therapy, the patient＇s symptoms improved. Conclusions Airway invasive aspergillosis is uncommon. Aspergillus in the airway lumen grows as lumps, it causes bronchial obstruction and expansion, accompanies rapid progression and strong invasion. Early adequate anti-fungal therapy and bronchoscopy involvement of local high-frequency coagulation therapy can lead to satisfactory results.