Pulmonary and Extrapulmonary Manifestations of Fungal Infections Misdiagnosed as Tuberculosis: The Need for Prompt Diagnosis and Management.
Pulmonary and Extrapulmonary Manifestations of Fungal Infections Misdiagnosed as Tuberculosis: The Need for Prompt Diagnosis and Management.
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DOI：
10.3390/jof8050460
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发表时间：
2022-04-28
期刊：
影响因子：
4.7
通讯作者：
Denning, David W.
中科院分区：
文献类型：
--
作者：
Ekeng, Bassey E.;Davies, Adeyinka A.;Osaigbovo, Iriagbonse I.;Warris, Adilia;Oladele, Rita O.;Denning, David W.
真菌感染通常表现出与其他临床实体相似的无数症状，其中值得注意的是结核病。除了组织胞浆菌病和慢性肺曲霉菌病可以模拟结核病外，这篇综述还发现了其他几种真菌感染也可以模拟结核病。共80例误诊为结核病：曲霉病18例(22.5%)，组织胞浆菌病16例(20%)，芽孢霉病14例(17.5%)，隐球菌病11例(13.8%)，球孢子菌病7例(8.8%)，球孢子菌病5例(6.3%)，毛霉病4例(5%)，孢子丝菌病3例(3.8%)，淡色丝孢菌病1例(1.3%)，嗜铬芽孢霉菌病1例(1.3%)。来自印度和巴基斯坦的病例系列报告了100多例慢性和过敏性支气管肺曲霉菌病在做出正确诊断之前接受了抗结核治疗。预后良好者45例(56.3%)，死亡25例(33.8%)，其余患者预后不明者。人类免疫缺陷病毒(HIV)感染17例(21.3%)。诊断方法包括组织病理学(n=46，57.5%)、培养(n=42，52.5%)、血清学(n=18，22.5%)、细胞学(n=2，2.5%)、基因测序(n=5，6.3%)和显微镜(n=10，12.5%)。我们的结论是，只要患者出现未经证实的结核症状，就应始终考虑或排除上述真菌感染，从而减少与延迟或错误诊断真菌感染相关的长时间住院和死亡率。
Fungal infections commonly present with myriad symptoms that mimic other clinical entities, notable amongst which is tuberculosis. Besides histoplasmosis and chronic pulmonary aspergillosis, which can mimic TB, this review has identified several other fungal infections which also do. A total of 80 individual cases misdiagnosed as TB are highlighted: aspergillosis (n = 18, 22.5%), histoplasmosis (n = 16, 20%), blastomycosis (n = 14, 17.5%), cryptococcosis (n = 11, 13.8%), talaromycosis (n = 7, 8.8%), coccidioidomycosis (n = 5, 6.3%), mucormycosis (n = 4, 5%), sporotrichosis (n = 3, 3.8%), phaeohyphomycosis (n = 1, 1.3%) and chromoblastomycosis (n = 1, 1.3%). Case series from India and Pakistan reported over 100 cases of chronic and allergic bronchopulmonary aspergillosis had received anti-TB therapy before the correct diagnosis was made. Forty-five cases (56.3%) had favorable outcomes, and 25 (33.8%) died, outcome was unclear in the remainder. Seventeen (21.3%) cases were infected with human immunodeficiency virus (HIV). Diagnostic modalities were histopathology (n = 46, 57.5%), culture (n = 42, 52.5%), serology (n = 18, 22.5%), cytology (n = 2, 2.5%), gene sequencing (n = 5, 6.3%) and microscopy (n = 10, 12.5%) including Gram stain, India ink preparation, bone marrow smear and KOH mount. We conclude that the above fungal infections should always be considered or ruled out whenever a patient presents with symptoms suggestive of tuberculosis which is unconfirmed thereby reducing prolonged hospital stay and mortalities associated with a delayed or incorrect diagnosis of fungal infections.
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影响因子：
11.8
作者：
Denning, DW;Riniotis, K;Sambatakou, H
通讯作者：
Sambatakou, H
影响因子：
2
作者：
Callens, SFJ;Kitetele, F;Colebunders, R
通讯作者：
Colebunders, R
影响因子：
0.9
作者：
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通讯作者：
Argaud, Laurent
DOI：
10.3390/jof3040057
发表时间：
2017-10-18
期刊：
Journal of fungi (Basel, Switzerland)
影响因子：
--
作者：
Bongomin F;Gago S;Oladele RO;Denning DW
通讯作者：
Denning DW
DOI：
10.1590/s0037-86822010000500010
发表时间：
2010-10-01
影响因子：
2
作者：
Alves, Sydney Hartz;Boettcher, Cecília Schubert;Santurio, Janio Morais
通讯作者：
Santurio, Janio Morais