肺隱球菌病（PC）是一種由隱球菌感染引起的急性或亞急性肺部真菌病。好發(fā)于免疫功能低下者。在HIV感染者中，PC的發(fā)生率為5%~10%。非HIV感染者，PC發(fā)病的危險(xiǎn)因素包括：結(jié)節(jié)病、關(guān)節(jié)炎、Crohn’s病、結(jié)締組織病、腎小球腎炎、糖尿病、腫瘤、實(shí)體器官移植受者、接受抗腫瘤壞死因子α治療、接受激素治療或免疫抑制劑治療等。約15%的PC患者沒(méi)有基礎(chǔ)疾病，屬于免疫功能健全者。有研究發(fā)現(xiàn)免疫功能健全的PC發(fā)病與患者吸煙史、既往激素治療史和曾有腫瘤史相關(guān)[1]，這可能與這類(lèi)患者存在自然免疫缺陷有關(guān)[2]?；颊邲](méi)有任何肺原發(fā)病癥和肺結(jié)構(gòu)異常而形成PC感染稱(chēng)為原發(fā)性隱球菌型肺炎，約50%是發(fā)生在免疫功能健全的患者中，大多數(shù)患者肺為單一受累器官。
引用本文： 盛華,瞿介明. 肺隱球菌病的診斷和治療. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2010, 9(1): 107-109. doi: 復(fù)制
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| 1. | Jarvis JN,Harrison TS.Pulmonary cryptococcosis.Semin Respir Crit Care Med,2008,29:141-150. |
| 2. | Marroni M,Pericolini E,Cenci E,et al.Functional defect of natural immune system in an apparent immunocompetent patient with pulmonary cryptococcosis.J Infect,2007,54:e5-8. |
| 3. | Warnock DW.Trends in the epidemiology of invasive fungal infections.Nippon Ishinkin Gakkai Zasshi,2007,48:1-12. |
| 4. | Chen J,Varma A,Diaz MR,et al.Cryptococcus neoformans strains and infection in apparently immunocompetent patients,China.Emerg Infect Dis,2008,14:755-762. |
| 5. | Khawcharoenporn T,Apisarnthanarak A,Mundy LM.Non-neoformans cryptococcal infections: a systematic review.Infection,2007,35:51-58. |
| 6. | Bernicker EH,Atmar RL,Schaffner DL,et al.Unanticipated diagnoses found at autopsy in an urban public teaching hospital.Am J Med Sci,1996,311:215-220. |
| 7. | Mitchell DH,Sorrell TC.Pancoast’s syndrome due to pulmonary infection with Cryptococcus neoformans variety gattii.Clin Infect Dis,1992,14:1142-1144. |
| 8. | Lehmann PF,Morgan RJ,Freimer EH.Infection with Cryptococcus neoformans var.gattii leading to a pulmonary cryptococcoma and meningitis.J Infect,1984,9:301-306. |
| 9. | Vilchez RA,Linden P,Lacomis J,et al.Acute respiratory failure associated with pulmonary cryptococcosis in non-aids patients.Chest,2001,119:1865-1869. |
| 10. | Nadrous HF,Antonios VS,Terrell CL,et al.Pulmonary cryptococcosis in nonimmunocompromised patients.Chest,2003,124:2143-2147. |
| 11. | Lortholary O,Nunez H,Brauner MW,et al.Pulmonary cryptococcosis.Semin Respir Crit Care Med,2004,25:145-157. |
| 12. | Chang WC,Tzao C,Hsu HH,et al.Pulmonary cryptococcosis: comparison of clinical and radiographic characteristics in immunocompetent and immunocompromised patients.Chest,2006,129:333-340. |
| 13. | Yang CJ,Hwang JJ,Wang TH,et al.Clinical and radiographic presentations of pulmonary cryptococcosis in immunocompetent patients.Scand J Infect Dis,2006,38:788-793. |
| 14. | Lindell RM,Hartman TE,Nadrous HF,et al.Pulmonary cryptococcosis: CT findings in immunocompetent patients.Radiology.2005,236:326-331. |
| 15. | 陳康. 原發(fā)性肺隱球菌病的光鏡和超微結(jié)構(gòu)觀(guān)察.第三軍醫(yī)大學(xué)學(xué)報(bào)，2005,27:244-246. |
| 16. | Baddley JW,Perfect JR,Oster RA,et al.Pulmonary cryptococcosis in patients without HIV infection: factors associated with disseminated disease.Eur J Clin Microbiol Infect Dis.2008,27:937-943. |
| 17. | Jarvis JN,Dromer F,Harrison TS,et al.Managing cryptococcosis in the immunocompromised host.Curr Opin Infect Dis,2008,21:596-603. |
| 18. | Saag MS,Graybill RJ,Larsen RA,et al.Practice guidelines for the management of cryptococcal disease.Infectious Diseases Society of America.Clin Infect Dis,2000,30:710-718. |
| 19. | Aberg JA.Pulmonary cryptococcosis in normal hosts: treat or observe? Chest,2003,124:2049-2051. |
| 20. | Thursky KA,Playford EG,Seymour JF,et al.Recommendations for the treatment of established fungal infections.Intern Med J,2008,38:496-520. |
- 1. Jarvis JN,Harrison TS.Pulmonary cryptococcosis.Semin Respir Crit Care Med,2008,29:141-150.
- 2. Marroni M,Pericolini E,Cenci E,et al.Functional defect of natural immune system in an apparent immunocompetent patient with pulmonary cryptococcosis.J Infect,2007,54:e5-8.
- 3. Warnock DW.Trends in the epidemiology of invasive fungal infections.Nippon Ishinkin Gakkai Zasshi,2007,48:1-12.
- 4. Chen J,Varma A,Diaz MR,et al.Cryptococcus neoformans strains and infection in apparently immunocompetent patients,China.Emerg Infect Dis,2008,14:755-762.
- 5. Khawcharoenporn T,Apisarnthanarak A,Mundy LM.Non-neoformans cryptococcal infections: a systematic review.Infection,2007,35:51-58.
- 6. Bernicker EH,Atmar RL,Schaffner DL,et al.Unanticipated diagnoses found at autopsy in an urban public teaching hospital.Am J Med Sci,1996,311:215-220.
- 7. Mitchell DH,Sorrell TC.Pancoast’s syndrome due to pulmonary infection with Cryptococcus neoformans variety gattii.Clin Infect Dis,1992,14:1142-1144.
- 8. Lehmann PF,Morgan RJ,Freimer EH.Infection with Cryptococcus neoformans var.gattii leading to a pulmonary cryptococcoma and meningitis.J Infect,1984,9:301-306.
- 9. Vilchez RA,Linden P,Lacomis J,et al.Acute respiratory failure associated with pulmonary cryptococcosis in non-aids patients.Chest,2001,119:1865-1869.
- 10. Nadrous HF,Antonios VS,Terrell CL,et al.Pulmonary cryptococcosis in nonimmunocompromised patients.Chest,2003,124:2143-2147.
- 11. Lortholary O,Nunez H,Brauner MW,et al.Pulmonary cryptococcosis.Semin Respir Crit Care Med,2004,25:145-157.
- 12. Chang WC,Tzao C,Hsu HH,et al.Pulmonary cryptococcosis: comparison of clinical and radiographic characteristics in immunocompetent and immunocompromised patients.Chest,2006,129:333-340.
- 13. Yang CJ,Hwang JJ,Wang TH,et al.Clinical and radiographic presentations of pulmonary cryptococcosis in immunocompetent patients.Scand J Infect Dis,2006,38:788-793.
- 14. Lindell RM,Hartman TE,Nadrous HF,et al.Pulmonary cryptococcosis: CT findings in immunocompetent patients.Radiology.2005,236:326-331.
- 15. 陳康. 原發(fā)性肺隱球菌病的光鏡和超微結(jié)構(gòu)觀(guān)察.第三軍醫(yī)大學(xué)學(xué)報(bào)，2005,27:244-246.
- 16. Baddley JW,Perfect JR,Oster RA,et al.Pulmonary cryptococcosis in patients without HIV infection: factors associated with disseminated disease.Eur J Clin Microbiol Infect Dis.2008,27:937-943.
- 17. Jarvis JN,Dromer F,Harrison TS,et al.Managing cryptococcosis in the immunocompromised host.Curr Opin Infect Dis,2008,21:596-603.
- 18. Saag MS,Graybill RJ,Larsen RA,et al.Practice guidelines for the management of cryptococcal disease.Infectious Diseases Society of America.Clin Infect Dis,2000,30:710-718.
- 19. Aberg JA.Pulmonary cryptococcosis in normal hosts: treat or observe? Chest,2003,124:2049-2051.
- 20. Thursky KA,Playford EG,Seymour JF,et al.Recommendations for the treatment of established fungal infections.Intern Med J,2008,38:496-520.