真菌性肺炎
WordNet
- respiratory disease characterized by inflammation of the lung parenchyma (excluding the bronchi) with congestion caused by viruses or bacteria or irritants
- of or relating to fungi (同)fungous
PrepTutorEJDIC
- 肺炎
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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/08/10 22:51:00」(JST)
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| Fungal pneumonia |
| Classification and external resources |
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Micrograph of showing a fungal pneumonia (pulmonary aspergillosis). H&E stain.
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Fungal pneumonia is an infection of the lungs by fungi. It can be caused by either endemic or opportunistic fungi or a combination of both. Case mortality in fungal pneumonias can be as high as 90% in immunocompromised patients,[1][2] though immunocompetent patients generally respond well to anti-fungal therapy.
Contents
- 1 Causes
- 2 Pathophysiology
- 3 Diagnosis
- 4 Treatment
- 5 See also
- 6 Notes and references
- 7 External links
Causes
Specific instances of fungal infections that can manifest with pulmonary involvement include:
- histoplasmosis, which has primary pulmonary lesions and hematogenous dissemination
- coccidioidomycosis, which begins with an often self-limited respiratory infection (also called "Valley fever" or "San Joaquin fever")
- pulmonary blastomycosis
- pneumocystis pneumonia, which typically occurs in immunocompromised people, especially AIDS
- sporotrichosis — primarily a lymphocutaneous disease, but can involve the lungs as well
- cryptococcosis — contracted through inhalation of soil contaminated with the yeast, it can manifest as a pulmonary infection and as a disseminated one
- aspergillosis, resulting in invasive pulmonary aspergillosis
- rarely, candidiasis has pulmonary manifestations in immunocompromised patients.
- Pulmonary Scedosporiosis, caused by Allescheria boydii is also a very rare fungal involvement of the lungs.[3]
Pathophysiology
Fungi typically enter the lung with inhalation of their spores, though they can reach the lung through the bloodstream if other parts of the body are infected. Also, fungal pneumonia can be caused by reactivation of a latent infection. Once inside the alveoli, fungi travel into the spaces between the cells and also between adjacent alveoli through connecting pores. This invasion triggers the immune system to respond by sending white blood cells responsible for attacking microorganisms (neutrophils) to the lungs. The neutrophils engulf and kill the offending organisms but also release cytokines which result in a general activation of the immune system. This results in the fever, chills, and fatigue common in bacterial and fungal pneumonia. The neutrophils and fluid leaked from surrounding blood vessels fill the alveoli and result in impaired oxygen transportation.
Diagnosis
Fungal pneumonia can be diagnosed in a number of ways. The simplest and cheapest method is to culture the fungus from a patient's respiratory fluids. However, such tests are not only insensitive but take time to develop which is a major drawback because studies have shown that slow diagnosis of fungal pneumonia is linked to high mortality.[4] Microscopy is another method but is also slow and imprecise. Supplementing these classical methods is the detection of antigens. This technique is significantly faster but can be less sensitive and specific than the classical methods.[5]
A molecular test based on quantitative PCR is also available from Myconostica. Relying on DNA detection, this is the most sensitive and specific test available for fungi but it is presently limited to detecting only pneumocystis jirovecii and aspergillus.[6]
Treatment
Fungal pneumonia can be treated with antifungal drugs and sometimes by surgical debridement.
See also
- Pneumonia
- Medusoid Mycelium
Notes and references
- ^ Meersseman W, Lagrou K, Maertens J, Van Wijngaerden E (July 2007). "Invasive aspergillosis in the intensive care unit". Clin. Infect. Dis. 45 (2): 205–16. doi:10.1086/518852. PMID 17578780.
- ^ Bulpa P, Dive A, Sibille Y (October 2007). "Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease". Eur. Respir. J. 30 (4): 782–800. doi:10.1183/09031936.00062206. PMID 17906086.
- ^ Meshram, Sushant; Mishra Gyanshankar (December 2011). "Pulmonary scedosporiosis–A rare entity". Asian Pacific Journal of Tropical Disease 1 (4): 330–332. doi:10.1016/S2222-1808(11)60076-5. Retrieved 14 February 2013.
- ^ Morrell M, Fraser VJ, Kollef MH (September 2005). "Delaying the empiric treatment of candida bloodstream infection until positive blood culture results are obtained: a potential risk factor for hospital mortality". Antimicrob. Agents Chemother. 49 (9): 3640–5. doi:10.1128/AAC.49.9.3640-3645.2005. PMC 1195428. PMID 16127033.
- ^ Denning, D (September 2008). "Webinar on fungal diagnostics" (PDF).
- ^ , Philippe Hauser, Lagrou K, Cui X, PerlinD S, Park S, Harrison E, Meerssman W, Hughes M J, Bowyer P, Denning DW, Bille J, Lass-Flor C, Maertens J. Clinical performance of FXG : RESP (Asp +) assay for Aspergillus spp. and Pneumocystis jirovecii on respiratory specimens. Unpublished Data.
External links
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Pathology of respiratory system (J, 460–519), respiratory diseases
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Upper RT
(including URTIs,
Common cold) |
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Head
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- sinuses
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Neck
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- larynx
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- vocal folds
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- Vocal fold nodule
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- epiglottis
- Epiglottitis
- trachea
- Tracheitis
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Lower RT/lung disease
(including LRTIs) |
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Bronchial/
obstructive
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- acute
- Acute bronchitis
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- COPD
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- Acute exacerbations of chronic bronchitis
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- Emphysema)
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Interstitial/
restrictive
(fibrosis) |
External agents/
occupational
lung disease |
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Other
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- ARDS
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- Respiratory hypersensitivity
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Obstructive or
restrictive
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Pneumonia/
pneumonitis
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By pathogen
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- Viral
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- Mycoplasma
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By vector/route
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By distribution
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IIP
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Other
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- Atelectasis
- circulatory
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Pleural cavity/
mediastinum |
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Pleural disease
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- Pneumothorax/Hemopneumothorax
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Mediastinal disease
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- Mediastinitis
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| Other/general |
- Respiratory failure
- Influenza
- SARS
- Idiopathic pulmonary haemosiderosis
- Pulmonary alveolar proteinosis
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anat (n, x, l, c)/phys/devp
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noco (c, p)/cong/tumr, sysi/epon, injr
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proc, drug (R1/2/3/5/6/7)
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Pneumonia
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| Infectious pneumonias |
- Bacterial pneumonia
- Viral pneumonia
- Fungal pneumonia
- Parasitic pneumonia
- Atypical pneumonia
- Community-acquired pneumonia
- Healthcare-associated pneumonia
- Hospital-acquired pneumonia
- Ventilator-associated pneumonia
- Severe acute respiratory syndrome
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Pneumonias caused by
infectious or noninfectious agents |
- Aspiration pneumonia
- Lipid pneumonia
- Eosinophilic pneumonia
- Bronchiolitis obliterans organizing pneumonia
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| Noninfectious pneumonia |
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anat (n, x, l, c)/phys/devp
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noco (c, p)/cong/tumr, sysi/epon, injr
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proc, drug (R1/2/3/5/6/7)
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UpToDate Contents
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English Journal
- From the acta prize lecture 2014: the periodontal-systemic connection seen from a microbiological standpoint.
- Olsen I1.
- Acta odontologica Scandinavica.Acta Odontol Scand.2015 Nov;73(8):563-8. doi: 10.3109/00016357.2015.1007480. Epub 2015 Apr 20.
- OBJECTIVE: To give an overview of the periodontal-systemic connection seen from a microbiologist.METHODS: Original research papers, review articles and workshop proceedings were consulted.RESULTS: Periodontal bacteria can cross epithelial cells, enter the circulation, invade endothelial cells, induc
- PMID 25891035
- Experimental pulmonary fibrosis in rats with chronic gastric acid reflux esophagitis.
- Shimazu R1, Aoki S2, Kuratomi Y3.
- Auris, nasus, larynx.Auris Nasus Larynx.2015 Oct;42(5):382-4. doi: 10.1016/j.anl.2015.03.005. Epub 2015 Apr 8.
- OBJECTIVE: To elucidate the association between gastric acid reflux and respiratory diseases by studying the histological changes of the lower airway in rats with chronic acid reflux esophagitis.METHODS: An experimental rat model of chronic acid reflux esophagitis was surgically created. The lower a
- PMID 25863641
- Halothane Modulates the Type I Interferon Response to Influenza and Minimizes the Risk of Secondary Bacterial Pneumonia through Maintenance of Neutrophil Recruitment in an Animal Model.
- MacDonald BA1, Chakravarthy KV, Davidson BA, Mullan BA, Alluri R, Hakansson AP, Knight PR.
- Anesthesiology.Anesthesiology.2015 Sep;123(3):590-602. doi: 10.1097/ALN.0000000000000766.
- BACKGROUND: To minimize the risk of pneumonia, many anesthesiologists delay anesthesia-requiring procedures when patients exhibit signs of viral upper respiratory tract infection. Postinfluenza secondary bacterial pneumonias (SBPs) are a major cause of morbidity and mortality. An increased host susc
- PMID 26120770
Japanese Journal
- 日本病理剖検輯報からみた真菌症の疫学 - 2011 年 update
- 鈴木 裕子,大戸 斉,栂野 富輝,久米 光
- Medical Mycology Journal 56(3), J99-J103, 2015
- 日本病理剖検輯報を対象として，2011 年 (第54輯) の解析を行った．全剖検例 12,339 例中，内臓真菌症は 608 例 (4.9 %) にみられ，その内訳は男性 411 例 (67.6 %)，年齢中央値 67 歳，重篤例 353 (58.1 %)．起因真菌では，<I>Aspergillus</I> 269 例 (44.5 %) と従来通り，<I>As …
- NAID 130005097609
- 急性リンパ性白血病の寛解導入療法中に発症した鼻脳型ムーコル症例
- 牧原 靖一郎,石原 久司,宮武 智実,津村 宗近,野田 洋平,檜垣 貴哉,假谷 伸,岡野 光博,西﨑 和則
- 日本鼻科学会会誌 54(1), 31-37, 2015
- 急性浸潤型副鼻腔真菌症は眼窩や脳内に進展し極めて難治性で予後不良な疾患である。今回，急性リンパ性白血病の寛解導入療法中に発症し，不幸な転機となった鼻脳型ムーコル症の一例を経験したため，文献的考察を加えて報告する。症例は74歳，女性。当院血液内科で急性リンパ性白血病と診断され，入院2日目より寛解導入療法を開始した。治療開始後から徐々に左視力低下，軽い左眼周囲の痛みを感じ，入院21日目より左眼瞼腫脹， …
- NAID 130005072821
- Voriconazole-responsive Disseminated Nodular Lesions on Spinal MRI
- Hirota Seiko,Ito Shinji,Fukui Takao,Murate Kenichiro,Shima Sayuri,Kizawa Madoka,Ueda Akihiro,Asakura Kunihiko,Mutoh Tatsuro
- Internal Medicine 54(2), 215-218, 2015
- … She was in an immunosuppressed state following the administration of methylprednisolone therapy for idiopathic interstitial pneumonia. … We suspected a diagnosis of seronegative deep mycosis and initiated anti-fungal therapy with voriconazole, which subsequently alleviated all of the patient's symptoms and MRI findings. …
- NAID 130004903008
Related Links
- Fungal pneumonia is an infection of the lungs by fungi. It can be caused by either endemic or opportunistic fungi or a combination of both. Case mortality in fungal pneumonias can be as high as 90% in immunocompromised patients, though ...
- 6 Mar 2013 ... Fungal pneumonia is an infectious process in the lungs caused by 1 or more endemic or opportunistic fungi. Fungal infection occurs following the inhalation of spores, after the inhalation of conidia, or by the reactivation of a ...
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