CAJ | 학술논문

目的提高对发热伴血小板减少综合征、侵袭性肺曲霉病及两病并发的临床特点的认识。方法结合1例发热伴血小板减少综合征并侵袭性肺曲霉病患者的临床资料及文献复习，对本病的临床表现、实验室指标检查、影像学、诊断和治疗进行分析。结果发热伴血小板减少综合征以发热伴全身乏力为主要表现，可出现肝、肾、心、凝血等多脏器多功能损伤，白细胞和血小板计数均减少。侵袭性肺曲霉病在难以取得病理的情况下，应紧密结合其高危因素、临床症状、影像学及痰培养、G试验和GM试验等做出临床诊断，尽早治疗以降低病死率。结论发热伴血小板减少综合征并侵袭性肺曲霉病临床罕见，其发生可能由于发热伴血小板减少综合征急性期白细胞计数减少、免疫力低下，导致侵袭性肺曲霉病等机会性感染的发生。
목적제고대발열반혈소판감소종합정、침습성폐곡매병급량병병발적림상특점적인식。방법결합1례발열반혈소판감소종합정병침습성폐곡매병환자적림상자료급문헌복습，대본병적림상표현、실험실지표검사、영상학、진단화치료진행분석。결과발열반혈소판감소종합정이발열반전신핍력위주요표현，가출현간、신、심、응혈등다장기다공능손상，백세포화혈소판계수균감소。침습성폐곡매병재난이취득병리적정황하，응긴밀결합기고위인소、림상증상、영상학급담배양、G시험화GM시험등주출림상진단，진조치료이강저병사솔。결론발열반혈소판감소종합정병침습성폐곡매병림상한견，기발생가능유우발열반혈소판감소종합정급성기백세포계수감소、면역력저하，도치침습성폐곡매병등궤회성감염적발생。
Objective To improve our understanding of the clinical features of severe fever with thrombocytopenia syndrome (SFTS) and invasive pulmonary aspergillosis (IPA). Methods The clinical manifestations, laboratory tests, radiographic, diagnosis and treatment of SFTS with IPA were analyzed by the clinical data of a patient with both of the two diseases through the literature review. Results Fever and malaise were the main clinical manifestations of SFTS. Damage of multiple-organ (such as liver, kidney, heart and coagulation) and leukocytopenia and thrombocytopenia may occur. As it was hard to get the pathological data of lung, IPA should be diagnosed through risk factors, clinical symptoms, radiographic, sputum culture, serum galactomannan and plasma 1,3-β-D glucan measurement so as to start empirical antifungal treatment as early as possible and reduce the mortality. Conclusions The occurrence of SFTS with IPA is rare in clinic. Patient with SFTS may have hypoimmunity and leukocytopenia in acute phase, leading to opportunistic infections, such as IPA.