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
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
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