人类感染弯孢菌(C.lunata)异常罕见。一名23岁的女性患者在甲型流感病毒感染期间同时感染了细菌和弯孢菌感染。由于病情波动,住院期间重复进行了多种病因检查。入院后第17天,在其中一项检查中,在患者支气管肺泡灌洗液的病原体培养中发现了霉菌菌丝。该患者被怀疑患有丝状真菌感染。因此,我们进一步获得了用于真菌培养的痰液样本,这证实了弯孢菌感染的诊断。病人,在这种情况下,情况危急,经历肺脓肿的并发症,气胸,脓毒症,多器官衰竭。尽管在检测到真菌感染并同时给予积极的器官功能支持治疗后迅速开始抗真菌治疗,包括两性霉素B胆固醇硫酸酯复合物和伊沙武康唑,由于免疫功能受损,患者的病情迅速恶化。最终,在治疗的第27天,患者死于感染性休克和多器官功能障碍综合征。这是我院首例弯孢菌感染病例。在本文中,我们旨在提高对弯孢菌感染的认识,并强调甲型流感病毒引起的重症肺炎患者应考虑这种真菌感染的可能性,当患者有侵袭性肺损伤时,应及时进行经验性抗真菌治疗.
Human infection with
Curvularia lunata (C. lunata) is exceptionally rare. A 23-year-old female patient contracted both bacterial and
Curvularia lunata infections during influenza A virus infection. Multiple etiological tests were performed repeatedly during hospitalization due to fluctuations in condition. On the 17th day after hospital admission, mold hyphae were discovered in the pathogen culture of the patient\'s bronchoalveolar lavage fluid during one of these examinations. The patient was suspected to have a filamentous fungal infection. Consequently, we further obtained sputum samples for fungal culture, which confirmed the diagnosis of
Curvularia infection. The patient, in this case, was in a critical condition, experiencing complications of lung abscess, pneumothorax, sepsis, and multiorgan failure. Despite prompt initiation of antifungal therapy including amphotericin B cholesteryl sulfate complex and isavuconazole upon detection of the fungal infection and concurrent administration of active organ function support treatment, the patient\'s condition rapidly deteriorated due to compromised immune function. Ultimately, on the 27th day of treatment, the patient succumbed to septic shock and multiple organ dysfunction syndrome. This is the first case of
Curvularia lunata infection in our hospital. In this paper, we aim to raise awareness of
Curvularia lunata infection and to emphasize that the possibility of this fungal infection should be considered in patients with severe pneumonia caused by influenza A virus and that empirical antifungal therapy should be given promptly when the patient has invasive lung damage.