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中国真菌学杂志 2022, Vol. 17  Issue (6): 486-489.

病例报告 上一篇    下一篇

烟曲霉感染性心内膜炎1例

周宸1, 卢家桀2   

  1. 1. 四川大学华西医院华西临床医学院, 成都 610041;
    2. 四川大学华西医院感染性疾病中心, 成都 610041
  • 收稿日期:2022-01-26 发布日期:2023-01-04
  • 通讯作者: 卢家桀,E-mail:10955415@qq.com E-mail:10955415@qq.com
  • 作者简介:周宸,女(汉族),博士研究生在读.E-mail:zhouchen961121@163.com

A case of Aspergillus fumigatus endocarditis

ZHOU Chen1, LU Jiajie2   

  1. 1. West China School of Medicine, West China Hospital, Sichuan University, Chengdu 610041, China;
    2. Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu 610041, China
  • Received:2022-01-26 Published:2023-01-04

摘要: 烟曲霉感染性心内膜炎诊断难、致死率高、预后差。报道1例烟曲霉感染性心内膜炎患者经宏基因组下一代测序(metagenomics next-generation sequencing,mNGS)检出烟曲霉,接受伏立康唑治疗并通过监测其血药浓度(therapeutic drug monitoring,TDM)以确保临床疗效和安全性。经过药物联合手术治疗,患者好转出院。因此mNGS在曲霉感染导致的心内膜炎的诊断中有重要的意义。在治疗方面,通过TDM调整伏立康唑的用量,既能保证疗效,又减少了药物不良反应的发生,为烟曲霉感染性心内膜炎的内科治疗提供了一种安全有效的诊疗选择。

关键词: 烟曲霉, 感染性心内膜炎, 伏立康唑, 血药浓度监测

Abstract: Aspergillus fumigatus infective endocarditis was characterized as difficult in diagnosis and with high mortality and poor prognosis. We reported a case of infective endocarditis, identified by next-generation metagenomic sequencing (mNGS) as Aspergillus fumigatus. The patient was treated with voriconazole and therapeutic drug monitoring (TDM) was performed to ensure efficacy and safety. Being conbined with surgical treatment, the patient got better and was discharged. Therefore, mNGS played an important role in the diagnosis of endocarditis caused by Aspergillus infection. Adjusting the dose of voriconazole by TDM can not only ensure the curative effect, but also reduce the occurrence of adverse reactions, providing a safe and effective treatment choice of Aspergillus fumigatus infective endocarditis.

Key words: Aspergillus fumigatum, infective endocarditis, voriconazole, therapeutic drug monitoring(TDM)

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