The value of the current diagnostic criteria of pulmonary invasive fungal infection after allogeneic hematopoietic stem cell transplantation
10.3760/cma.j.issn.0578-1426.2013.03.012
- VernacularTitle:异基因造血干细胞移植后肺部侵袭性真菌感染现行诊断标准的应用价值
- Author:
Jianliang SHEN
;
Lizhong GONG
;
Daihong LIU
;
Xiaojun HUANG
- Publication Type:Journal Article
- Keywords:
Hematopoietic stem cell transplantation;
Diagnostic criteria;
Invasive fungal infection
- From:
Chinese Journal of Internal Medicine
2013;(3):221-224
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the practicality of current diagnostic criteria of invasive fungal infection (IFI) in patients with hematologic diseases/malignant tumors,so as to enhance the recognition of characteristics of pulmonary IFI after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods The clinical features of 51 cases with IFI after allo-HSCT were analyzed retrospectively.Results Pulmonary IFI accounted for 42.1％ (51/121) of the whole infectious pneumonia diagnosed among the patients admitted during the study.One (2.0％) case was proven diagnosis ; 24 (47.1％) were probable diagnosis and 26(51.0％) were possible diagnosis.The using of immuno-suppressors and corticosteroids,and the presence of graft-versus-host disease (GVHD) were the main host factors.The patients with two or more host factors simultaneously accounted for 66.7％ (34/51) of all pulmonary IFI patients.Totally 94.1％ (48/51) of the patients with pulmonary IFI presented nodules and/or patches as the main features in high resolution computed tomography (HRCT) scanning.The positive rates of fungal antigen detection were 58.6％ for G test and 33.3％ for GM test,which were relatively high.Twenty patients (39.2％) showed decrease of arterial partial pressure of oxygen and hypoxia in blood-gas analysis.Conclusions For the diagnosis of pulmonary IFI post allo-HSCT,the administration of immuno-suppressors and corticosteroids,and the presence of GVHD were the main host factors.Nodules and/or patches were the main features in HRCT image.Fungus antigen detection is the main tool to support clinical diagnosis.
