文档介绍：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(invasive fungal infections,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-IFICG & NIAID-MSG
Defining invasive fungal infection
Host factor
Clinical feature
Mycology
Invasive Fungal Infections Cooperative Group
Mycoses
Study
Group
Ascioglu et al 2002
Clin Infect Dis 34 7-14
Defining infection - Clinical features
Clinical feature
Invasive Fungal Infections Cooperative Group
Mycoses
Study
Group
Halo sign
Air-crescent sign
cavity
Lower respiratory tract infection
Sinonasal infection
CNS infection
Disseminated fungal infection
Chronic disseminated candidiasis
Radiological evidence
Radiological evidence
Unexplained papular or nodular skin lesions
Chorioretinitis
endophthalmitis
Bull’s eye lesions in liver or spleen
MAJOR
Ascioglu et al 2002
Clin Infect Dis 34 7-14
≥ 1
Defining infection - Clinical features
Clinical feature
Invasive Fungal Infections Cooperative Group
Mycoses
Study
Group
Cough. chest pain. haemoptysis. dyspnoea
Physical finding of pleural rub
Any new infiltrate not fulfilling major criterion
Lower respiratory tract infection
Sinonasal infection
CNS infection
Nasal discharge. stuffiness
Nose ulceration. eschar or epistaxis
Periorbital swelling
Maxillary tenderness
Black necrotic lesions or perforation of the hard-palate
CSF No pathogens
no malignant cells
abnormal biochemistry
abnormal cell count
Focal neurological
seizures
hemiparesis
cranial nerve palsy
Mental changes
Meningeal irritation
MINOR
Ascioglu et al 2002
Clin Infect Dis 34 7-14
≥ 2
Defining infection - Mycology
Mycology
antigen in BAL. CSF or blood
Culture of mould from tissue. aspirate BAL or sputum
mould seen in sinus aspirate
Fungi seen in tissue or sterile body fluids
Invasive Fungal Infections Cooperative