肋骨隐球菌感染2例报道并文献复习

中国真菌学杂志　 2020, Vol. 15 　Issue (5): 278-282.

肋骨隐球菌感染2例报道并文献复习

黄进宝¹, 兰长青², 翁恒¹, 林清华³

1. 福建医科大学教学医院福建省福州肺科医院呼吸与危重症医学科, 福州 350008;
2. 福建医科大学教学医院福建省福州肺科医院影像科, 福州 350008;
3. 福建医科大学教学医院福建省福州肺科医院病理科, 福州 350008

收稿日期:2020-01-03 出版日期:2020-10-28 发布日期:2020-10-28
通讯作者: 翁恒,E-mail:1552856821@qq.com E-mail:1552856821@qq.com
作者简介:黄进宝,男(汉族),硕士,主治医师.E-mail:huangnbao0@126.com
基金资助:
福建省2018年临床重点专科建设项目（闽卫医政函[2018]145号）

Cryptococcal infection of the ribs mimicking malignant tumor: two cases report and literature review

HUANG Jin-bao¹, LAN Chang-qing², WEN Heng¹, LIN Qing-hua³

1. Department of Respiratory and Critical Care Medicine, Fuzhou Pulmonary Hospital of Fujian, Educational Hospital of Fujian Medical University, Fuzhou 350008, China;
2. Department of Radiology, Fuzhou Pulmonary Hospital of Fujian, Educational Hospital of Fujian Medical University, Fuzhou 350008, China;
3. Department of Pathology, Fuzhou Pulmonary Hospital of Fujian, Educational Hospital of Fujian Medical University, Fuzhou 350008, China

Received:2020-01-03 Online:2020-10-28 Published:2020-10-28

摘要/Abstract

摘要：

目的探讨肋骨隐球菌感染的临床和影像特征。方法报道2例经病理确诊的肋骨隐球菌感染的临床表现，并结合国内外相关报道进行文献回顾分析。结果病例1为37岁男性，表现为咳嗽、咳血痰、右胸痛，胸部CT示右侧第5肋骨破坏伴局部软组织影，病灶穿刺活检病理确诊为肋骨隐球菌感染，经外科手术和氟康唑治疗4个月后治愈。病例2为31岁男性，表现为咳嗽、咳血痰、胸痛，胸部CT示双侧肋骨破坏伴局部软组织影，病灶穿刺活检病理确诊为肋骨隐球菌感染，经氟康唑治疗6个月后治愈。结论单纯肋骨隐球菌感染较为罕见，容易与肿瘤、结核等疾病相混淆，确诊主要依赖组织活检病理检查，经抗真菌药物和/或手术治疗预后良好。

关键词: 隐球菌, 骨, 氟康唑, 体层摄影术,X线技术

Abstract:

Objective To study the characteristics of cryptococcal infection of the ribs. Method Two cases of cryptococcal infection of the ribs were described and literatures were reviewed. Results Case 1:A 37-old-man with hepatitis B virus carrier was admitted to our hospital complaining of cough, phlegm with blood and right chest pain for one month. A chest CT showed the right 5^th rib destruction with adjacent lumpy soft tissue. The patient was diagnosed with cryptococcal infection of the rib by pathological examination. He received surgery and anti-fungal drug treatment for 4 months and was stable without recurrence during the 3-year follow-up period. Case 2:A 31-old-man with thrombopenia was admitted to our hospital complaining of cough, phlegm with blood for 3 months and chest pain for 2 weeks. A chest CT showed mutiple rib destructions with adjacent lumpy soft tissue in the both sides. The patient was diagnosed with cryptococcal infection of the ribs by pathological examination. He was treated with anti-fungal drug for 6 months and was stable without recurrence during the 2-year follow-up period. Conclusions Solitary cryptococcal infection of the ribs is rare, and it is easily confused with tumor, tuberculosis and other diseases. The diagnosis depends mainly on histopathological examination. The patients can be obtained satisfactory results after treatment.

Key words: Cryptococcus, bone, fluconazole, tomography,X-ray computed

中图分类号:

R519.4

黄进宝, 兰长青, 翁恒, 林清华. 肋骨隐球菌感染2例报道并文献复习[J]. 中国真菌学杂志, 2020, 15(5): 278-282.

HUANG Jin-bao, LAN Chang-qing, WEN Heng, LIN Qing-hua. Cryptococcal infection of the ribs mimicking malignant tumor: two cases report and literature review[J]. Chinese Journal of Mycology, 2020, 15(5): 278-282.

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