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世界核心医学期刊文摘（儿科学分册） 2005年第9期1卷 41-41页

作者： Ritz N. Ammann R.A. aebischer c.c. c. Aebi 王经纬 Department of Paediatrics University of Bern Inselspital 3010 Bern Switzerland

Voriconazole is increasingly used as a first-line agent for empirical antifungal therapy of prolonged febrile neutropenia in paediatric.c.ncer patients. We describe the case of a 9-yearold patient with stage IV Burkitt lymphoma, who developed pulmonary and splenic zygomycosis while receiving voriconazole for persistent febrile neutropenia. The causative agent, Absidia corymbifera,was identified by broad-range fungalPcR in a lung biopsy sample. The patient was successfully treated with a combination of partial resection of the left upper lobe and antifungal therapy with high-dose liposomal amphotericin B followed by oral itraconazole as demonstrated by resolving pulmonary infiltrates on serial high resolution cT scans. conclusion: This case emphasises that the lack of in vitro activity of voriconazole against zygomycetes is clinically relevant. Failure of voriconazole in suspected fungal infection should be investigated for the possibility of zygomycosis. Broad-range polymerase chain reaction may be able to identify the causative organism when cultures remain sterile.

关键词：接合菌病伏立康唑免疫缺陷播散性两性霉素真菌感染伯基特淋巴瘤持续性发热左上肺叶发热性

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囊性纤维化患者中过敏性支气管肺曲霉病的危险因素及烟曲霉菌的致敏作用

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世界核心医学期刊文摘（儿科学分册） 2006年第2期2卷 19-20页

作者： Ritz N. Ammann R.A. casaulta aebischer c. M.H. Schoeni 朱新菊 Department of Paediatrics University of Berne 3010 Berne Switzerland

An increasing incidence of allergic bronchopulmonary aspergillosis (ABPA) as a complication in patients with cystic fibrosis (cF) is reported. The objective of this retrospective case-control study was to assess potential risk factors for ABPA and for Aspergillus fumigatus sensitisation (AFS). In a group of 160 cF patients, 11 (7% ) fulfilled the diagnostic.c.iteria for ABPA and 20 (13% ) had evidence of AFS. They were compared to 62 control cF patients (25 for ABPA and 37 for AFS group) without evidence of ABPA or AFS using extended matching for sex, age and weight. AFS patients had received significantly higher cumulative doses of inhaled corticosteroids than their respective controls (OR 8.0; 95% cI 1.74-63). Bronchial colonisation with Stenotropho monasmaltophilia was strongly and independently associated with ABPA (OR 20; 95% cI 2.8-infinity). A longer duration of Pseudomonas aeruginosa colonisation was independently associated with AFS (OR per year 1.50; 95% cI 1.12-infinity). conclusion: cystic fibrosis patients with allergic bronchopulmonary aspergillosis have a more frequent isolation of S. maltophilia in their sputum than their controls. Longer duration of colonisation with P. aeruginosa is a risk factor for Aspergillus fumigatus sensitisation. Higher cumulative doses of inhaled corticosteroids are associated with Aspergillus fumigatus sensitisation and their role as a risk factor needs to be clarified.

关键词：潜在危险因素囊性纤维化支气管内肺曲霉病致敏作用烟曲霉菌过敏性患者嗜麦芽黄单胞菌病例对照研究

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