Résumé
Objective To investigate the status of invasive fungal infection(IFI)associated with hematopathy,and evaluate drug resistance and risk factors of fungal infection.Methods 1 246 cases of infection occurred in patients in a hospital from 2006 to 2010 were analyzed retrospectively,pathogenic features and risk factors of IFI were ana-lyzed.Results There were 281 cases of fungal infection,and 162 fungal isolates were isolated,the main infection site was respiratory tract(134 isolates,82.72%).Four major Candida were Candida albicans ,Candida tropicalis , Candida glabrata ,and Candida krusei ;in 2006-2009,the main fungi were Candida albicans ,while in 2010,the majority were non-Candida albicans .The resistant rates of four isolated Candida to fluconazole and itraconazole were 5.15% and 4.41 % respectively,6 isolated Candida krusei strains were all resistant to both fluconazole and itraconazole,voriconazole-resistant strain was not found.The independent risk factors for fungal infection were dia-betes and duration time of agranulocytosis>14 days.Conclusion The proportion of infection caused by non-Candi-da albicans increased obviously,fluconazole-and itraconazole-resistant non-Candida albicans strains have emerged, comprehensive measures should be adopted to prevent IFI actively and treat patients early.
Résumé
Objective To explore the diagnostic value of video bronchoscope-guide transbronchial needle aspiration(TBNA) combined with transbronchial lung biopsy(TBLB) on pulmonary sarcoidosis.Methods Twenty-two patients,definitely diagnosed as stage Ⅰ pulmonary sarcoidosis,were enrolled into the study and accepted TBNA and TBLB.Results The positive diagnostic rates of TBNA and TBLB were 63.6%(14/22) and 40.9%(9/22),but the rate increased to 90.9%(20/22) when the two methods were used together,which showed significant differences(x2=12.24,4.66,P＜0.01 or ＜0.05).Conclusion TBNA combined TBLB test is a safety method with high diagnostic accuracy for pulmonary sarcoidosis.
Résumé
Objective To study the main clinical characters of recurrent sarcoidosis.Methods Sarcoidosis recurrence were defined as presenting activity through imaging or histology after having self-relief or treated relief.There were 12 patients who consistent to the standard in all sarcoidosis patients from 2004 to 2008 in our hospital.Results All patients but one were male.The time of recurrent to the remission was from 4 to 38 months.10 patients received oral steroid therapy.Recurrences often occurred in drug reducing or 6 months after drug withdrawal.There were 2 patients with recurrence time greater than 3 years after remission.Three patients presented new organ damages in recurrence.Conclusions The recurrence of sarcoidosis mostly occurred in the course of drug reduction or in the early stage of drug withdrawal and the recurrence time were hardly over 3 years after remission.The sarcoidosis patients must receive long time follow-up and the program of oral steroid therapy must be standardized.