Standard operating procedure of the indwelling nasal cannula with or without anchoring for the treatment of pulmonary mycosis / 天津医药

Systemic application of effective antifungal drugs is the basic treatment for pulmonary mycosis,meanwhile,drug spraying under bronchoscope is one of the most important treatment options for tracheal,bronchial and pulmonary mycosis.Compared with bronchoscopic drug injection,indwelling guided drug injection cannula through nasal suspension with or without anchoring has more advantages in the treatment of pulmonary mycosis,including the ability to connect to a syringe pump for continuous and slow injection of drugs,which can avoid repeatedly performing bronchoscopy.This article describes the standard operating procedure of indwelling nasal cannula with or without anchoring for the treatment of pulmonary mycosis.

Not all Nodules Are Cancer and not all Fungal Infections Are Aspergillus.

Pithomyces, a dematiaceous fungus, is a common colonizer of dead leaves and stems of many different plants and is associated with facial eczema in some animals. We report a case of invasive fungal pulmonary disease by Pithomyces chartarum in a healthy, nonimmunocompromised patient. We aim to demonstrate our diagnostic and therapeutic approach and focus on the major challenges arising from the lack of scientific evidence regarding infection by this fungus in humans.

Pithomyces, um fungo demáceo, é um colonizador comum de folhas e caules de diferentes plantas e está associado a eczema facial em alguns animais. Neste trabalho, descrevemos um caso de infeção fúngica invasiva pelo fungo Pithomyces chartarum, numa mulher não imunocomprometida. O nosso objetivo é descrever a abordagem diagnóstica e terapêutica deste caso, realçando os principais desafios que surgem devido à falta de evidência científica relativamente à infeção deste fungo em humanos.

Clinical efficacy of caspofungin combined with voriconazole in the treatment of older adult patients with pulmonary fungal infection / 中国基层医药

Objective:To investigate the clinical efficacy of caspofungin combined with voriconazole in the treatment of older adult patients with pulmonary fungal infection and its effects on pulmonary function and inflammatory factors.Methods:A total of 100 patients with pulmonary fungal infection admitted to Hangzhou Ninth People's Hospital from January 2016 to December 2020 were included in this study. They were randomly assigned to undergo treatment with either voriconazole (control group, n = 50) or caspofungin combined with voriconazole (observation group, n = 50) for 14 consecutive days. Clinical efficacy and changes in pulmonary function and inflammatory factors after treatment relative to before treatment were determined in each group. Results:Total response rate in the observation group was significantly higher than that in the control group [90.00% (45/50) vs. 74.00% (37/50), χ2 = 4.33, P < 0.05). After treatment, forced vital capacity, forced expiratory volume in 1 second, and maximum expiratory flow rate in the observation group were (2.31 ± 0.77) L, (79.30 ± 6.72)%, (86.14 ± 7.27)%, respectively, which were significantly higher than (1.78 ± 0.74) L, (73.22 ± 6.56)%, (78.16 ± 7.09)% in the control group ( t = 3.50, 4.57, 5.55, all P < 0.05). Tumor necrosis factor α, interleukin-6, and procalcitonin levels in the observation group were (8.32 ± 1.41) ng/L, (35.19 ± 3.40) μg/L, (1.94 ± 0.78) ng/L, respectively, which were significantly lower than (10.15 ± 1.58) ng/L, (46.09 ± 3.64) μg/L, (2.43 ± 0.84) ng/L in the control group ( t = 6.11, 15.43, 3.02, all P < 0.05). The incidence of adverse reactions in the observation group was 4.0% (2/50), which was significantly lower than 18.0% (9/50) in the control group ( χ2 = 5.00, P < 0.05). Conclusion:Caspofungin combined with voriconazole for the treatment of pulmonary fungal infection in older adult patients can effectively improve pulmonary function, inhibit the inflammatory response, and have no obvious adverse reactions with accurate clinical efficacy.

Necrosis pulmonar masiva por micosis / Massive pulmonary necrosis due to mycosis

Introducción: La aspergilosis es una infección micótica oportunista que se presenta fundamentalmente en pacientes inmunodeprimidos y su principal fuente de transmisión lo constituyen las esporas presentes en el aire de salones de operaciones y unidades de cuidados intensivos. Objetivo: Presentar un caso de una micosis pulmonar masiva por una variante angioinvasiva de Aspergillus. Caso clínico: Se presenta un paciente con aspergilosis pulmonar grave, diagnosticada después de la resección de un tumor mediastinal. Se describen las características de la primera intervención, la evolución postoperatoria que condujo a la segunda, se muestran las imágenes tomográficas, quirúrgicas, microbiológicas y anátomo-patológicas que permitieron definir el diagnóstico. Conclusiones: La posibilidad de una micosis pulmonar debe tenerse en cuenta, aun cuando sea una afección rara y de manejo difícil, en pacientes inmunodeprimidos, con condensación pulmonar rebelde al tratamiento(AU)

Introduction: Aspergillosis is an opportunistic fungal infection that occurs mainly in immunosuppressed patients and its main source of transmission is the spores present in the air of operating rooms and intensive care units. Objective: To present a case of a massive pulmonary mycosis due to an angioinvasive variant of Aspergillus. Clinical case: A patient with severe pulmonary aspergillosis, diagnosed after resection of a mediastinal tumor, is presented. The characteristics of the first intervention are described, the postoperative evolution that led to the second one, the tomographic, surgical, microbiological and anatomo-pathological images that allowed to define the diagnosis are shown. Conclusions: The possibility of a pulmonary mycosis should be taken into account, even when it is a rare and difficult-to-handle condition, in immunocompromised patients, with pulmonary condensation that is rebellious to treatment. Aspergillosis is an opportunistic fungal infection that occurs mainly in immunosuppressed patients and its main source of transmission is the spores present in the air of operating rooms and intensive care units(AU)

How could hypoglycemia-inducing glycogen storage disease lead to hyperglycemia-induced mucormycosis?

Mucormycosis is an increasingly frequent, difficult to diagnose, difficult to treat, often fatal infection, especially in patients with hyperglycemia from uncontrolled diabetes. Type I (von Gierke) glycogen storage disease is due to inherited deficiency of enzymes in glycogen metabolism, which causes hypoglycemia. This report is the case of a patient with von Gierke disease and a missed diagnosis of pulmonary mucormycosis. This report illustrates the importance of having a high index of suspicion for mucormycosis in the appropriate clinical context.

How could hypoglycemia-inducing glycogen storage disease lead to hyperglycemia-induced mucormycosis?

Mucormycosis is an increasingly frequent, difficult to diagnose, difficult to treat, often fatal infection, especially in patients with hyperglycemia from uncontrolled diabetes. Type I (von Gierke) glycogen storage disease is due to inherited deficiency of enzymes in glycogen metabolism, which causes hypoglycemia. This report is the case of a patient with von Gierke disease and a missed diagnosis of pulmonary mucormycosis. This report illustrates the importance of having a high index of suspicion for mucormycosis in the appropriate clinical context.

Burden of Fungal Infections in Colombia.

Data with respect to the epidemiological situation of fungal diseases in Colombia is scarce. Thus, the aim of this study is to estimate the burden of fungal infections. A population projection for 2017 from the Colombian Department for National Statistics was used, as well as official information from the Ministry of Health and National Institute of Health. A bibliographical search for Colombian data on mycotic diseases and population at risk (chronic obstructive pulmonary disease, HIV infection/AIDS, cancer, and transplant patients) was done. The Colombian population for 2017 was estimated at 49,291,609 inhabitants, and the estimated number of fungal infections for Colombia in 2017 was between 753,523 and 757,928, with nearly 600,000 cases of candidiasis, 130,000 cases of aspergillosis, and 16,000 cases of opportunistic infection in HIV, affecting around 1.5% of the population. In conclusion, fungal infections represent an important burden of disease for the Colombian population. Different clinical, epidemiological, and developmental scenarios can be observed in which fungal infections occur in Colombia.

AAcute WT1-positive promyelocytic leukemia with hypogranular variant morphology, bcr-3 isoform of PML-RARα and Flt3-ITD mutation: a rare case report / Leucemia promielocítica aguda WT1-positivo com morfologia variante hypogranular, isoforma bcr-3 da PML-RARα e mutação Flt3-ITD: relato de caso raro

ABSTRACT CONTEXT: Acute promyelocytic leukemia (APL) accounts for 8% to 10% of cases of acute myeloid leukemia (AML). Remission in cases of high-risk APL is still difficult to achieve, and relapses occur readily. CASE REPORT: Here, we describe a case of APL with high white blood cell counts in blood tests and hypogranular variant morphology in bone marrow, together with fms-like tyrosine kinase-3 with internal tandem duplication mutations (FLT3-ITD), and bcr-3 isoform of PML-RARα. Most importantly, we detected high level of Wilms’ tumor gene (WT1) in marrow blasts, through the reverse transcription polymerase chain reaction (RT-PCR). To date, no clear conclusions about an association between WT1 expression levels and APL have been reached. This patient successively received a combined treatment regimen consisting of hydroxycarbamide, arsenic trioxide and idarubicin plus cytarabine, which ultimately enabled complete remission. Unfortunately, he subsequently died of sudden massive hemoptysis because of pulmonary infection. CONCLUSION: Based on our findings and a review of the literature, abnormal functioning of WT1 may be a high-risk factor in cases of APL. Further studies aimed towards evaluating the impact of WT1 expression on the prognosis for APL patients are of interest.

RESUMO CONTEXTO: Leucemia promielocítica aguda (LPA) compreende 8% a 10% dos casos de leucemia mieloide aguda (LMA). A remissão em casos de LPA de alto risco ainda é dificilmente conseguida, e recorrência é comum. RELATO DE CASO: Descrevemos aqui um caso de LPA com glóbulos brancos elevados no exame de sangue e a morfologia variante hipogranular na medula óssea, juntamente com fms-like tirosina-quinase-3 com mutações de duplicação em tandem interna (FLT3-ITD) e a isoforma bcr-3 de PML- RARα. Mais importante, detectamos alto nível de gene do tumor de Wilms (WT1) em blastos medulares por RT-PCR (reverse transcription polimerase chain reaction). Até agora, não há conclusões claras sobre a associação entre os níveis de expressão WT1 e APL. Este paciente recebeu sucessivamente regime de tratamento combinado, de hidroxicarbamida, trióxido de arsênico e idarrubicina e citarabina, alcançando finalmente a remissão completa. Infelizmente, em seguida, ele morreu de repente de hemoptise maciça devido a uma infecção pulmonar. CONCLUSÃO: Com base em nossos resultados e numa revisão da literatura, a função anormal de WT1 pode ser um fator de alto risco em casos de APL. Novos estudos, com o objetivo de avaliar o impacto da expressão de WT1 no prognóstico dos doentes com APL, são de interesse.

Pulmonary immune responses against Aspergillus fumigatus are characterized by high frequencies of IL-17 producing T-cells.

In healthy individuals and in patients with invasive aspergillosis, Aspergillus-specific T-cells in peripheral blood display mainly a Thelper1 phenotype. Although in other fungal infections Thelper17 immunity is important, it was suggested that in aspergillus infection Thelper17 cells do not play a role or may even be detrimental. OBJECTIVES: To compare the cytokine profiles of Aspergillus-specific CD4+ T-cells in peripheral blood and in the lung. To investigate the Thelper phenotype at the primary location of A. fumigatus exposure. METHODS: Lung-derived T-cells and peripheral blood T-cells from COPD-patients were stimulated with overlapping peptides of 6 A. fumigatus proteins. Aspergillus-specific T-cells were identified on the basis of the activation marker CD154 and production of TNFα. In addition, production of the cytokines IFNγ, IL-17, IL-4 and IL-5 by the Aspergillus-specific T-cells was measured. RESULTS: The majority of lung-derived Aspergillus-specific T-cells displayed a Thelper17 phenotype, and only low percentages of cells produced IFNγ. In contrast, in the peripheral blood of COPD patients Aspergillus-specific T-cells displayed a Thelper1 phenotype, similar as peripheral blood-derived Aspergillus-specific T-cells from healthy individuals. CONCLUSIONS: These data demonstrate that in A. fumigatus infection, similar as in other fungal infections, Thelper17 cells may play a more important role in the immune response than was appreciated until now.

Clinical effect of voriconazole in the treatment of invasive fungal infections in lung cancer patients with ;radiotherapy and chemotherapy / 中国基层医药

Objective To investigate the clinical effect of voriconazole in the treatment of invasive fungal infections in lung cancer patients with radiotherapy and chemotherapy,to provide a reference for clinical treatment. Methods The clinical data of 64 lung cancer patients with radiotherapy and chemotherapy with invasive fungal infec-tions were retrospectively analyzed.According to the treatment methods,they were divided into control group and observation group,32 cases in each group.Fluconazole treatment was used in the control group,and the observation group used voriconazole therapy.The overall response rate,time to return to normal white blood cells and other indica-tors of liver and kidney function were compared between the two groups.Results The effective rate of the observation group was 81.25%,which was significantly higher than 68.75% of the control group,the difference was statistically significant(χ2 =5.876,P=0.008).The temperature recovery,cough disappeared,leukocyte recovery time of the observation group were (3.61 ±0.61)d,(6.11 ±0.81)d,(7.85 ±0.92)d,which were significantly shorter than those of the control group,the differences were statistically significant(t=4.145,P=0.025;t=4.045,P=0.027;t=4.385,P=0.021).The treatment of the two groups had mild liver and kidney damage,and there was no signifi-cant difference between the two groups(all P>0.05 ).Conclusion Voriconazole treatment has good clinical effect for lung cancer patients after radiotherapy and chemotherapy with invasive fungal infections,the treatment period is short,but with mild liver and kidney function impairment,the treatment should strengthen the monitoring.

Recent advances in diagnosis of invasive pulmonary fungal infection / 中国基层医药

The number of IPFI has increased in recent years because of the increasing of immunocompromised hosts due to abuse of antibiotics,glucocorticoids,immunosuppressants and all kinds of invasive operations,organ transplants.The mortality of IPFI remains highly because it's difficult to early diagnosis.Histopathologic biopsy remains as the gold standard for IPFI diagnosis although limited by materials.Imaging manifestations are nonspecific but have important suggestive values to some kinds of fungus.Direct examination is quickly but it's difficult to distinguish strain.Fungal culture can guide the treatment but its positive rate is low and the distinguish for contamination,infection and colonization is hard.Serological test has high sensitivity and specificity,but it cannot distinguish strain and it can yield false positives and false negative.Molecular biology is one of rapid developing methods,but its application is limited due to lack of standardized procedures and standards to assess its results,furthermore it can yield false positives.The proper diagnosis for IPFI relies on the comprehensive assessment combing with advantages and disadvantages of various methods.

Clinical features and risk factors for patients with liver failure complicated by invasive pulmonary aspergillosis / 临床肝胆病杂志

ObjectiveTo investigate the clinical features and risk factors for patients with liver failure complicated by invasive pulmonary aspergillosis (IPA), and to provide a reference for clinical diagnosis and treatment. MethodsThe clinical data of 477 patients with liver failure who were diagnosed and treated in Henan Provincial People′s Hospital from January 2010 to December 2014 were collected, and the clinical features, laboratory markers, and results of imaging examinations of patients with IPA were retrospectively analyzed. Another 49 patients with liver failure who were hospitalized within the same period, had similar ages, and were not complicated by pulmonary infection were randomly selected as controls. The independent samples t-test was used for comparison of continuous data between groups, the chi-square test or Fisher′s exact test were used for comparison of categorical data between groups, and multivariate logistic regression analysis was performed to analyze the risk factors for liver failure complicated by IPA. ResultsAmong the 447 patients with liver failure, 43(96%) were complicated by IPA. Age (P=0.023), hepatic encephalopathy (P=0.021), long-term use of broad-spectrum antibiotics (P=0.007), use of hormone (P=0.016), and deep venous catheterization (P＜0.001) were independent risk factors for the development of IPA. Clinical manifestations of liver failure patients with IPA lacked specificity. Lung CT scan showed multiple nodules, masses, and wedge-shaped consolidation near the pleura in both lungs, but typical halo sign and air crescent sign were rarely seen. Among the 35 patients who received antifungal therapy, 30 were improved or cured, 3 died of digestive tract bleeding, 2 clied of plumonary infection, and all the other patients who did not receive therapy also died. ConclusionPatients with liver failure have various risk factors for the development of IPA, and the clinical manifestations are not typical, with high incidence and fatality rates. Early detection and treatment is the key to improving survival rates.

Aspergilose pulmonar necrotizante e aspergiloma pulmonar / Necrotizing pulmonary aspergillosis and pulmonary aspergilloma

A aspergilose pulmonar necrotizante ou semi-invasiva é um processo infecioso indolente, com consequente destruição do parênquima pulmonar, causado pela inalação de Aspergillus, geralmente Aspergillus fumigatus. O aspergiloma é caracterizado pelo desenvolvimento de uma bola fúngica numa cavidade pulmonar preexistente e pode ser visto em cerca de 50% dos doentes com aspergilose pulmonar necrotizante. Os autores apresentam um caso clínico de aspergilose pulmonar necrotizante e aspergiloma que, por sua gravidade clínica e coexistência de patologia pulmonar prévia grave, sem imunossupressão conhecida, ilustra as particularidades destas patologias.

Necrotizing pulmonary aspergillosis also called semi-invasive aspergillosis is an indolent, infectious and destructive process of the lung due to invasion by Aspergillus species, usually Aspergillus fumigatus. Aspergilloma (fungus ball) usually develops in a preexisting cavity in the lung and may be seen in nearly 50% of patients with Necrotizing pulmonary aspergillosis. The authors present a case report of necrotizing pulmonary aspergillosis and an aspergilloma with underlying chronic lung disease but without any known immunodeficiency, that illustrates the particularities of these diseases.

Aspergilosis traqueobronquial necrotizante en paciente crítico / Necrotizing tracheobronchial aspergillosis in an immunosuppressed patient. Report of one case

Necrotizing tracheobronchitis due to Aspergillus spp is a rare form of invasive aspergillosis. This infection is limited to or predominant in the bronchial tree. The clinical evolution is gradual: from mild non-specific manifestations of acute tracheobronchitis to severe acute respiratory insufficiency determined by a bronchial obstruction syndrome. We report a 38 years old female with systemic lupus erythematosus treated with methylprednisolone and cyclophosphamide. She developed an invasive aspergillosis, severe respiratory failure with predominant tracheobronchial damage and upper respiratory complications.

Computed tomography features of pulmonary nocardiosis in immunocompromised and immunocompetent patients.

BACKGROUND: Nocardiosis primarily occurs in the setting of immunocompromising conditions. However, it may also occur in immunocompetent patients. We described computed tomography features of pulmonary nocardiosis and compared immunocompetent and immunocompromised patients. MATERIAL/METHODS: CT images of 25 patients (Mean age of 39.5 years; 76% male) with pulmonary nocardiosis proved by bronchoalveolar lavage or biopsy were reviewed by two experienced pulmonary radiologists and detailed findings were reported on. Fourteen patients (56%) were immunocompetent, while 44% had an underlying immunocompromising condition, including chronic granulomatous disease (CGD) (n=4), diabetes mellitus (DM) (n=2), malignancy (n=2), HIV (n=1), concomitant CGD and DM (n=1), and steroid therapy for nephrotic syndrome (n=1). RESULTS: Most patients had bilateral involvement with no zonal predominance. Multiple pulmonary nodules (96%) were the most common CT findings, followed by consolidation (76%) and cavity (52%). Other findings included bronchiectasis (48%), pleural thickening (40%), ground glass opacity (32%), mass-like consolidation (20%), intrathoracic lymphadenopathy (16%), pleural effusion (12%), reticular infiltration (4%), and pericardial effusion (4%). There was no statistically significant difference in the CT findings of immunocompromised and immunocompetent groups. CONCLUSIONS: Pulmonary nocardiosis presents mainly as multiple pulmonary nodules, consolidations, and cavity in both immunocompromised and immunocompetent patients. However, these features are more suggestive of nocardiosis in the setting of an underling immunocompromised condition.

Imaging Features of Chest CT and Prognosis of Proven Pulmonary Invasive Fungal Disease After Hematopoietic Stem Cell Transplantation / 中国医学影像学杂志

Purpose To assess the initial and follow-up CT findings of proven pulmonary invasive fungal disease (IFD) in patients after hematopoietic stem cell transplantation (HSCT), and to look for the signs for the prognosis. Materials and Methods A retrospective investigation of the CT features and the evolution process was carried out in 13 patients with proven pulmonary IFD diagnosed by histological examination. Results The first abnormal CT finding showed single nodule or mass in 5 cases, two nodules or masses in 2 cases, multiple nodules or masses in 2 cases, patchy consolidation in 1 case, patchy ground glass opacity (GGO) in 1 case, multiple stripes and GGOs in 1 case, and multiple consolidations in peribronchial distribution in 1 case; the presence of reversed halo sign (RHS) was found in 7 cases, not including 4 cases with aspergillosis. The median initial diameter was 32.0 mm, and the median maximum diameter was 51.5 mm. 9 of them reached partial remission after drug treatment, and 9 accepted operation resection. In the end, there were 5 cases cured, 1 keeping stable, 2 suspected recurrent on imaging, and 5 dead. In summary, it showed less than 2 nodules or masses in 7 patients (group 1) and other imaging patterns in 6 patients (group 2), the former group had smaller max diameter (t=4.397, P<0.01), the effective rate within 12 weeks, operation resection rate and final cure rate of group 1 were 85.7%, 100.0% and 71.4%, and those of group 2 were 16.7%, 33.3% and 0, respectively, with group 1 all higher than group 2 (P<0.05). Conclusion Nodule or mass is the most common CT finding of pulmonary IFD in HSCT recipients, with high incidence of reversed halo sign, less than 2 nodules or masses on the first CT imaging may be associated with better prognosis.

Analysis of CT features of nodular or mass-like type of pulmonary cryptococcosis / 中华放射学杂志

Objective To investigate the CT features of nodular or mass-like type pulmonary cryptococcosis(PC). Methods A total of 52 cases with nodular or mass-like type PC confirmed by pathological examinations at Fuzhou Pulmonary Hospital of Fujian from January 2008 to December 2012 were studied. Each patient underwent a breath-hold MSCT scan and contrast enhanced CT was performed in 19 patients. The data including lesion size, number, distribution, density, performance of enhanced CT scan and accompanying signs were analyzed. Each CT accompanying sign was compared between nodular lesions and mass-like lesions using χ2 test,continuous correction χ2 test or Fisher exact test. Results Of all the 52 patients, pulmonary cryptococcosis was consisted single nodules/masses (21 cases) and multiple of nodules/masses (31 cases). There were total 206 lesions with 172 nodules and 34 masses. The lesions were mainly found in lower lobe(73.3%, 151/206)and outer zone or subpleura(87.4%, 180/206)of lung. Plain CT scan showed the densities of most lesions were solid and uniform(74.7%, 154/206). A total of 95 lesions were detected in the 19 patients with contrast enhanced CT, in which 61 lesions (64.2%) showed homogeneous enhancement and 86 lesions (90.5%) showed moderate enhancement. Nodular or mass-like lesions accompanied by many CT signs including halo sign (59.2%, 122/206), air bronchogram (32.0%, 66/206), pulmonary cavity or vocule sign (15.0%, 31/206), lobulation sign (25.2%, 52/206), spicule sign (13.1%, 27/206), pleural indentation(7.8%, 16/206) and vascular cluster (1.9%, 4/206). Compared with mass-like lesions, lobulation sign was more frequently observed in nodular lesions(χ2=13.750, P=0.001), whereas air bronchogram and pulmonary cavity orvocule sign were less frequently observed(χ2=19.957, P=0.001; χ2=5.295, P=0.021, respectively). No significant statistically differences were detected in other CT signs between them (P>0.05). Conclusions PC lesions usually occur in right lung, lower lobe and close to the pleura. Halo sign and air bronchogram are the characteristic findings of CT manifestations in nodular or mass-like type PC.

Role of plasma (1-3)-beta glucan D testing in curative effect evaluation of pulmonary fungal infection / 国际检验医学杂志

Objective To investigate the dynamic change and the clinical curative effect evaluation of plasma (1-3)-beta glucan D (BG) in the patients with pulmonary disease complicating fungal infection .Methods The MB-80 miroorganism dynamic rapid de-tection system and fungi BG detection kits were adopted to detect plasma BG content before and after treatment in 87 cases of pul-monary disease complicating fungal infection and the controls .The sputum culture in the patients was performed before and after treatment .Results Plasma BG levels before antifungal therapy ,at 1 ,2 weeks after treatment in 87 patients were (162 .81 ± 70 .03) , (15 .89 ± 30 .88) and (4 .58 ± 7 .87)pg/mL ,which in the control group was (5 .62 ± 1 .83)pg/mL ,plasma BG level had statistical differences between before treatment and at 1 ,2 weeks after treatment in the patients with the control group (P<0 .05);Plasma BG levels between at 1 week after treatment with at 2 weeks after treatment and the control group had statistically significant differ-ences (P<0 .05) .Among 87 patients ,66 cases were positive sputum culture at 1 week after antifungal drug treatment and 9 cases were positive sputum culture at 2 weeks after treatment .Conclusion Continuously monitoring the patient′s plasma BG level com-bined with the sputum fungal culture results ,clinical symptoms and lung shadow in X-ray has certain clinical value to judge the anti-fungal effect .

Contrast of therapeutic effects between voriconazole and fluconazole in treatment of pulmonary candidiasis / 中国基层医药

Objective To observe the efficacy and safety of voriconazole in the treatment for the patients infectedwith Candida species.Methods 79 patients were randomly divided into voriconazole treatment group and fluconasole treatment group.And they were enrolled and were administered voriconazole.Results The total effective rate of experimental group was 93.1％,and that of control group was 65.9％ and the difference was significant(P ＜0.05).the risk factors of the two groups showed no obvious difference.the adverse reaction incidence rate in voriconazole treatment group was 16.7％,And that in fluconazole treatment group was 14.0％,there was no significant difference between the two groups.Conclusion The application of voriconazole can receive better effect than that of fluconasole.And it has good clinical safety,and voriconazole is worthy of application in clinic for Candida infection.