伊曲康唑治疗肺曲霉瘤1例报告

1 资料与方法 1.1 临床资料 患者,男,46岁.主诉:咳嗽、咯痰、间断咯血3年.现病史:3年前(2001年6月)患者出现咳嗽、咯黄白色痰、间断咯血,伴发热,偶尔咯出黄绿色块状物,经抗生素(甲磺酸左氧氟沙星,商品名:利复星)治疗无效.既往病史:8年前曾患肺结核,正规抗结核治疗2年,结核治愈.     

伊曲康唑治愈泛发性体癣1例

泛发性体癣临床较少见,在临床中诊治本病患者1例,取得了满意疗效,报告如下： 1 临床资料 患者男53岁。职员。因腹部出现红斑伴瘙痒渐扩大30余天入院就诊。     

伊曲康唑治疗胃部真菌感染1例

患者因患陈旧性心肌梗死、脑梗塞,长期服药致胃黏膜损伤,同时合并糖尿病,引发胃部真菌感染,经口服伊曲康唑200mg,2次／d,治疗3周后痊愈。     

伊曲康唑序贯疗法治疗老年MODS患者侵袭性肺部真菌感染14例

目的 观察伊曲康唑序贯疗法治疗老年多脏器功能障碍综合征（MODS）患者侵袭性肺部真菌感染的疗效。方法 回顾分析重症监护病房（ICU）中,老年MODS患者侵袭性真菌感染14例,最初应用伊曲康唑注射液7～14d,第1～2d,200mg,1次／12h,第3～14d,200mg,1次／d;然后,采用伊曲康唑胶囊或口服液序贯治疗,400mg／d剂量水平,疗程2—4周。结果 临床有效率85．7％,真菌清除率为92．9％,真菌清除平均天数为6．1d;患者28d生存率85．7％,不良反应发生率为42．9％。结论 对老年MODS合并侵袭性真菌感染患者在综合治疗的基础上,应用广谱抗真菌药物——伊曲康唑序贯疗法,是巩固疗效,防止复发值得推广的给药方式。临床应用伊曲康唑时,应注意适应证、药物不良反应及药物的相互作用。     

伊曲康唑治疗花斑癣52例疗效观察

我们从1999年4月～2000年3月用伊曲康唑治疗花斑癣52例,获得满意疗效,现将结果报告如下 1材料与方法 1.1临床资料门诊选择经临床和真菌镜检确诊的花斑癣共52例.     

伊曲康唑治疗复发性念珠菌性生殖器感染98例的临床观察

本研究使用伊曲康唑（商品名美扶,天津力生制药生产）口服治疗复发性念珠菌性生殖器感染患者98例,获得了满意的疗效,现报告如下： 1资料与方法 1．1临床资料 196例患者均来自2000年1月～2005年6月本院皮肤科门诊,男性114例,女性82例,年龄19～55岁,年龄19～55岁,病程3个月～1年,复发次数最少2次;均经临床和真菌学检查确诊为念珠菌性生殖器感染患者。     

伊曲康唑治疗甲真菌病的疗效观察

本组于2000年3月～2005年6月对128例甲真菌病患者给予口服伊曲康唑胶囊（商品名：斯皮仁诺）治疗,采用间歇冲击疗法,治疗结果报告如下。 1 资料与方法 1．1 临床资料 128例患者均为门诊患者,男性73例,女性55例,年龄17～72岁,平均年龄36．5岁,病程2个月～45年。其中指甲真菌感染者32例（病甲48个）,趾甲真菌感染者72例（病甲377个）,指甲、趾甲均真菌感染者24例（病指甲35个,病趾甲103个）。近端甲下真菌病37例,远端甲下真菌病61例,白色甲下真菌病30例。其中32例伴有手癣,67例伴发足癣,19例伴发甲沟炎,2例伴有股癣。真菌直接镜检,镜下均可见菌丝及孢子。     

伊曲康唑治疗隐球菌性脑膜炎1例报告并文献复习

隐球菌性脑膜炎是一种严重危害人类健康的疾病,致死率和病残率均较高。伊曲康唑是三唑类广谱抗真菌药物,体外药敏试验显示其具有良好的抗隐球菌活性。但由于伊曲康唑难以通过血脑屏障,在脑脊液中的浓度较低,     

伊曲康唑治愈着色芽生菌病1例

着色芽生菌病（chromoblastomycosis）是由暗色真菌引起的皮肤及皮下组织的慢性肉芽肿性疾病。致病真菌常通过皮肤的微小外伤侵入,损害好发于四肢远端的暴露部位。临床表现为疣状增生性斑块或结节,病程持久,迁延不愈。最近我们用伊曲康唑治愈1例着色芽生菌病患者,报告如下。     

伊曲康唑治疗严重烧伤患者真菌感染的疗效分析

目的 评价伊曲康唑治疗严重烧伤患者真菌感染的疗效及其安全性。方法 采用开放、随机研究单组评估设计,治疗前2d：伊曲康唑注射液2次／d,间隔12h,200mg／次。此后1次／d,剂量200mg,间隔24h,1疗程14d。试验结束后口服伊曲康唑口服液维持治疗至少4周,2次／d,200mg／次。结果 伊曲康唑治疗23例严重烧伤患者总有效率为60．87％;本组86．96％的患者临床疗效为改善;63．64％的患者真菌学疗效为真菌清除;8．70％和52．17％的患者综合疗效分别为痊愈和显效,未发生不良反应。结论 伊曲康唑治疗严重烧伤患者真菌感染有良好的疗效、不良反应少。     

伊曲康唑对皮肤癣菌形态学影响研究

目的观察皮肤癣菌在伊曲康唑作用下的形态学变化。方法应用美国CLSI制订的标准M38-A方案进行伊曲康唑对皮肤癣菌的体外药敏试验,测定最小抑菌浓度（MIC）,将伊曲康唑作用前后的皮肤癣菌分别制成标本,在光学显微镜、扫描电子显微镜和透射电子显微镜下观察形态学变化。结果伊曲康唑作用于皮肤癣菌后,在光学显微镜下菌丝变得弯曲、短粗,顶端和局部出现膨大;扫描电子显微镜下菌丝变得弯曲、短粗、干瘪,顶端和局部出现膨大,有不规则分支,表面粗糙,有大小不等的凹陷;透射电子显微镜下菌丝变得皱缩,有凹陷,双层细胞壁结构消失或不完整,细胞膜不连续,皱缩细胞膜和细胞壁之间及胞浆内出现许多小的高电子密度颗粒,细胞器也变得不清晰。结论伊曲康唑使皮肤癣菌的形态发生明显变化。     

Mycetoma caused by Exophiala jeanselmei. Report of a case successfully treated with itraconazole and review of the literature

We report a case of black grain mycetoma in a 74-years-old man who presented with a 50-yr. history of sinus-tract formation in the right foot. This is the first case of an Exophiala jeanselmeimycetoma successfully treated with itraconazole. In addition a review of the literature on this subject was done.     

伊曲康唑注射剂治疗伴有肺结核史的侵袭性真菌感染2例

目的报道2例伴有肺结核史的侵袭性真菌感染经伊曲康唑注射剂治疗经过,探讨伴有肺结核史患者的抗真菌治疗经验。方法例1为49岁＂支气管肺囊肿合并感染,陈旧性肺结核＂男性患者,诊断为侵袭性肺曲霉感染确诊病例。例2为51岁＂右侧自发性气胸,慢性阻塞性肺病,陈旧性肺结核＂男性患者,诊断为侵袭性肺念珠菌感染拟诊病例。均予伊曲康唑注射剂治疗2周结合抗细菌治疗,并作临床和真菌学疗效监测。结果治疗两周后两患者临床症状和体征均得到明显改善,标本真菌镜检转阴,培养仍为阳性。结论在有肺结核病史存在的侵袭性真菌感染抗真菌治疗时间可能需要延长。合理应用抗生素、激素,严格掌握用药指针、时机、剂量与疗程是控制真菌感染的重要因素。     

Relapsed follicular lymphoma sequentially treated with rituximab and 90Y-ibritumomab tiuxetan. Case report

BACKGROUND: Monoclonal antibodies have dramatically changed the treatment possibilities for follicular lymphoma. (90)Y-ibritumomab tiuxetan (Zevalin) is the first radioimmunotherapy agent approved for the treatment of relapsed and resistant follicular lymphoma patients. Long-term benefit was observed especially for patients achieving CR after radioimmunotherapy. METHODS AND RESULTS: A 65-year-old female patient with the second relapse of CD20 positive follicular lymphoma and multiple concomitant diseases was treated with four weekly doses of rituximab (375 mg/m(2)). (18)F-fluoro-deoxyglucose positron emission tomography combined with computed tomography (PET-CT) demonstrated only partial response to therapy with persistent PET scan positivity in enlarged abdominal lymph nodes. Therefore, it was decided to treat her with a 1200-MBq (32-mCi) dose of (90)Y-ibritumomab tiuxetan radioimmunotherapy. No acute complications were noted afterwards. Hematological nadirs were reached 4 weeks later, with a platelet count of 24 x 10(9)/l that normalized within the next 2 weeks. The patient had neither infection nor bleeding complications. Eight weeks after radioimmunotherapy, the PET-CT scans documented only 3 lymph nodes around the abdominal aorta, maximum size 2 x 1 cm. The PET scan analysis proved no accumulation of (18)F-fluoro-deoxy-glucose in any lymph nodes or other organs and tissues. CONCLUSIONS: Sequential treatment with rituximab and (90)Y-ibritumomab tiuxetan may be an interesting alternative in cases of relapsed follicular or other indolent lymphomas in pretreated or older patients with other concomitant diseases.     

Cutaneous blastomycosis. An imported case with good response to itraconazole

BackgroundBlastomycosis is a subacute or chronic deep mycosis caused by a dimorphic fungus called Blastomyces dermatitidis, which generally produces a pulmonary form of the disease and, to a lesser extent, extra-pulmonary forms such as cutaneous, osteoarticular and genitourinary, among others. Cutaneous blastomycosis is the second clinical presentation in frequency. It is considered as primary when it begins by inoculation of the fungus due to traumas, and secondary when the lung fails to contain the infection.Case-reportWe present the case of a 57 year-old male who had a 5 year-history of an irregularly shaped verrucous infiltrative plaque related to and insect bite and posterior trauma due to the manipulation of the lesion. B. dermatitidis was identified using direct examination, stains, isolation in culture media, histopathology, and molecular studies. An antifungal susceptibility test was performed using method M38-A2 (CLSI). Clinical and mycological cure was achieved with itraconazole.ConclusionsThis cutaneous blastomycosis case acquired in the United States (Indianapolis) is rather interesting and looks quite similar to other mycoses such as coccidioidomycosis or sporotrichosis. The presented case shows one of the multiple issues concerning migration between neighboring countries.     

口服伊曲康唑治疗婴儿泛发性皮肤黏膜念珠菌病1例

随着低体重儿存活率的提高以及抗生素的广泛应用,婴儿皮肤、黏膜念珠菌病的患病率在逐年上升.本院1例9个月男婴,因喂养不当而诱发泛发性皮肤、黏膜念珠菌病,采用口服伊曲康唑100 mg隔日1次,治疗14 d后痊愈.     

面癣误诊1例

1资料与方法1.1临床资料患者,女,34岁,农民。因面部皮疹伴瘙痒4个月加重1周就诊。4个月前右侧面颊部出现一约黄豆大小红色环形皮损,伴瘙痒。当地诊所诊断为“过敏性皮炎”,给予外用“肤轻松”、“皮康霜”,同时口服扑尔敏治疗1周,皮疹减轻。停药后复发。此后曾在当地多家医院按“皮炎、湿疹”治疗,外用“皮炎平”“尿素软膏”“皮康王”,口服“息斯敏”“特非那丁”“赛庚啶”“西替利嗪”等药物。开始用药时红斑均略减轻,但皮疹反复发作且面积逐渐扩大。近一周来皮疹明显扩大,瘙痒加剧,遂于2005年12月27日来我科就诊。患者既往体健,无糖尿…     

支气管结石合并肺部盖尔森基兴奴卡菌感染1例

本文旨在通过对1例支气管结石伴盖尔森基兴奴卡菌肺炎患者的诊治过程进行回顾,并对相关文献进行复习,以提高临床医师对此类疾病的认识。该患者为结石性体质,胸部计算机断层扫描(computed tomography,CT)提示支气管内高密度影;无痛纤维支气管镜下确诊支气管内膜结石,给予患者支气管镜下碎石、取石,并送病理科行切片活检,同时行痰涂片、痰培养寻找病原体。结果成功在肺泡灌洗液中培养出盖尔森基兴奴卡菌,针对盖尔森基兴奴卡菌感染给予敏感药物治疗3个月后痊愈。支气管结石伴盖尔森基兴奴卡菌肺炎极其罕见,尤其局限于呼吸系统感染者更为少见。此类疾病需考虑支气管内膜结石所致支气管扩张等结构性疾病存在,导致局部抵抗力低下,从而引起条件致病菌盖尔森基兴奴卡菌感染。针对此类患者,建议及早行纤维支气管镜检查并完善灌洗液涂片、抗酸染色、灌洗液培养以获得病原学证据,为治疗赢得时间。控制盖尔森基兴奴卡菌感染后,需及早行纤维支气管镜下碎石等治疗,以纠正局部结构改变,减少再次感染机会。