这是第一份报告,描述了两个没有基础医疗条件的人因吸入沼气而引起的Scedosporiospermum和LichtheimiaCorymbifera的共同感染。两名患者在抢救另一名患者(此人几小时内死亡)的同时掉入同一猪粪坑内,并吸入沼气。两名患者均被诊断为肺部真菌病,并在第52天左右发展为急性肝功能衰竭。他们的结果对1,3-β-d-葡聚糖测试为阴性,对半乳甘露聚糖测试为弱阳性。他们未经手术接受两性霉素B和/或泊沙康唑治疗。病例2中的患者需要两性霉素B脱氧胆酸气雾剂吸入以完成治疗。两名患者完全康复。对于局限在肺部的毛霉菌病患者,不能耐受两性霉素B的静脉滴注,增加雾化给药的剂量可能是一种挽救方案。
This is the first report describing co-infection of Scedosporium apiospermum and Lichtheimia corymbifera caused by biogas inhalation in two people without underlying medical conditions. Two patients fell into the same pig manure pit at the same time while rescuing another patient (this person died in a few hours) and inhaled biogas. Both patients were diagnosed with pulmonary fungal disease and developed acute liver failure around Day 52. Their results were negative for the 1,3-β-d-glucan test and weakly positive for the galactomannan test. They were treated with amphotericin B and/or posaconazole without surgery. The patient in case 2 required amphotericin B deoxycholate aerosol inhalation to complete the treatment. Both patients recovered completely. For patients with mucormycosis confined to the lungs who cannot tolerate intravenous drip amphotericin B, increasing the dose of nebulised administration maybe a salvage regimen.