各类肺真菌病鉴别诊断

-5鉴别各类肺真菌病的主要线索宿主因素各类肺真菌的宿主因素存在差别某些肺真菌病患者可以没有免疫缺陷某些肺真菌病却几乎仅见于免疫缺陷患者临床表现和影像表现症状类型严重程度持续时间影像表现:差异大于共性ATSATS2011肺真菌病指南鉴别诊断之宿主因素?EORTC/MSG2008:HostfactorsforprobableorpossibleIFDRecenthistoryofneutropenia(<0.5×109neutrophils/Lfor>10days)temporallyrelatedtotheonsetoffungaldiseaseReceiptofanallogeneicstemcelltransplantProlongeduseofcorticosteroids(excludingamongpatientswithallergicbronchopulmonaryaspergillosis)atameanminimumdoseof0.3mg/kg/dayofprednisoneequivalentfor>3weeksTreatmentwithotherrecognizedTcellimmunosuppressants,suchascyclosporine,TNF-ablockers,specificmonoclonalantibodies(suchasalemtuzumab),ornucleosideanaloguesduringthepast90daysInheritedsevereimmunodeficiency(binedimmunodeficiency)ClinicalInfectiousDiseases2008;46:1813–21免疫缺陷并非必不可少的宿主因素肺隐球菌病合并免疫缺陷的比例低于其他各组P<0.0116家医院肺真菌病10年回顾性调查结果