真菌感染诊治指南ppt

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1、中国重症患者侵袭性真菌感染（IFI)诊断标准与治疗指南中国重症患者侵袭性真菌感染诊治指南工作组2006-11-18内容国外指南参考国内指南参考工作组成员指南框架指南分工时间进度表前言侵袭性真菌感染（invasivefungalinfections,IFI）的发病率明显上升。IFI也日益成为导致器官移植受者、恶性血液病和恶性肿瘤患者以及其他重病患者的死亡原因之一。为了规范我国重症患者IFI的诊断和治疗，中国重症患者侵袭性真菌感染工作组将参照欧美国家的相关诊断和治疗指南，并结合中国国情，制订出中国重症患者的IFI的诊断标准和治疗原则（草案）。EROTC诊断标准EORTC

2、-IFICG&NIAID-MSGDefininginvasivefungalinfectionHostfactorClinicalfeatureMycologyInvasiveFungalInfectionsCooperativeGroupMycosesStudyGroupAsciogluetal2002ClinInfectDis347-14Defininginfection-HostfactorsHostfactorneutropenia>4daysunexplainedfeverdespitebroadspectrumantibioticsGraftversus

3、HostDisease>3weekscorticosteroids<36°Cor>38°CandpriormycosisAIDSImmunosuppressivedrugs>10daysneutropeniaInvasiveFungalInfectionsCooperativeGroupMycosesStudyGroupAsciogluetal2002ClinInfectDis347-14Defininginfection-ClinicalfeaturesClinicalfeatureInvasiveFungalInfectionsCooperativeGroupM

4、ycosesStudyGroupHalosignAir-crescentsigncavityLowerrespiratorytractinfectionSinonasalinfectionCNSinfectionDisseminatedfungalinfectionChronicdisseminatedcandidiasisRadiologicalevidenceRadiologicalevidenceUnexplainedpapularornodularskinlesionsChorioretinitisendophthalmitisBull’seyelesion

5、sinliverorspleenMAJORAsciogluetal2002ClinInfectDis347-14≥1Defininginfection-ClinicalfeaturesClinicalfeatureInvasiveFungalInfectionsCooperativeGroupMycosesStudyGroupCough.chestpain.haemoptysis.dyspnoeaPhysicalfindingofpleuralrubAnynewinfiltratenotfulfillingmajorcriterionLowerrespiratory

6、tractinfectionSinonasalinfectionCNSinfectionNasaldischarge.stuffinessNoseulceration.escharorepistaxisPeriorbitalswellingMaxillarytendernessBlacknecroticlesionsorperforationofthehard-palateCSFNopathogensnomalignantcellsabnormalbiochemistryabnormalcellcountFocalneurologicalseizureshemipa

7、resiscranialnervepalsyMentalchangesMeningealirritationMINORAsciogluetal2002ClinInfectDis347-14≥2Defininginfection-MycologyMycologyantigeninBAL.CSForbloodCultureofmouldfromtissue.aspirateBALorsputummouldseeninsinusaspirateFungiseenintissueorsterilebodyfluidsInvasiveFungalInfectionsCoo