Fungal infection 黴菌感染相關議題

黴菌感染在臨床上是一個頗為棘手的問題，特別是發生在免疫不全的病人身上，需要特別的留意，除了在抗生素上的使用需注意抗菌譜外，也須根據臨床上的證據評估感染的可能性，給出合適的治療，避免走向嚴重併發症如敗血性休克及死亡。

黴菌分類 Fungus classification
Yeast - Candida spp., Cryptococcus spp., Trichosporon, Rhodotorula
Dimorphic - Blastomycosis, Paracoccidiomycosis, Coccidioidomycosis, Histoplasmosis, Sporotrichosis, Talaromyces
Mold - Aspergillus spp., Mucorymycosis, Fusariosis


抗黴菌圖譜 Anti-fungal agents spectrum

Reference:
1. Dodds Ashley, Elizabeth & Lewis, Russell & Lewis, James & Martin, Craig & Andes, David. (2006). Pharmacology of Systemic Antifungal Agents. Clinical Infectious Diseases - CLIN INFECT DIS. 43. 10.1086/504492.

黴菌感染臨床上判斷是否為疾病的三種可能性判斷，根據宿主因素、微生物學證據、病理切片、黴菌培養證據可分為Probable, Possible, Proven三種，再根據可能性投予抗黴菌用藥
Possible
1 host + 1 clinical but no mycobiological support
Probable
1 host + 1 microbiology + 1 clinical
Positive galactomannan or beta-D-glucan
Positive sputum or BAL culture
Prove
Histopathology + Culture