感染相关英文词汇-17曲霉感染

医学英文词汇小结-INFECTION15.7感染相关英文词汇小结真菌感染（15.7曲霉感染）Aspergillosis曲霉病(由曲霉属真菌引起的传染病，多见于鸟类)collectiveterm集合名词anyoneof-35pathogenicandallergenicspeciesofAspergillus由曲霉菌属中约35个致病、致敏的菌种引起growat37°Ccancauseinvasiveinfection在37°C生长的曲霉可造成侵袭性感染A.fumigatus烟曲霉chronicaspergillosis慢性曲霉菌病A.flavus黄曲霉cutaneousinfectionsandkeratitis皮肤感染及角膜炎A.niger黑曲霉colonizestherespiratorytractandcausesexternalotitis定植于呼吸道，还可造成外耳炎A.terreus土曲霉withapoorprognosis预后不良1

A.nidulans构巢曲霉chronicgranulomatousdisease慢性肉芽肿病decomposingplantmaterials腐败的植物compost堆肥hyaline(nonpigmented)透明的(无色素的)septate有隔膜的branchingmold分枝霉菌conidia(spores)抱子mycelialgrowth菌丝生长indoorandoutdoorair室内外空间均有Dailyexposuresvaryfromafewtomanymillionsofconidia每日接触的抱子可有数个至百万不等haybarns谷仓dustyenvironments肮脏的环境医学英文词汇小结-INFECTION15.7Therequiredsizeoftheinfectinginoculumisuncertain;致病所需菌种数量不明确27.intenseexposures（e.g.,duringconstructionwork,handlingofmoldybarkorhay,orcomposting）大量摄入（如：在建筑工地，接触并操作长霉木材干柴，堆肥）healthyimmunocompetentindividuals免疫功能正常的健康人Allergicsyndromesmaybeexacerbatedbycontinuousantigenicexposurearisingfromsinusorairwaycolonizationorfromnailinfection由窦道、呼吸道定植或指甲接触导致的长期抗原接触可加重过敏症状High-efficiencyparticulateair（HEPA）filtration高效微粒空气过滤protectiveagainstinfection防止感染monitoredforefficiency随时监测（HEPA）的效率Theincubationperiodofinvasiveaspergillosisafterexposureishighlyvariable,extendingindocumentedcasesfrom2to90days致病菌大量暴露后，侵袭性曲霉病的潜伏期长短不一，从已有记录的病例来看，最短2天，最长90天Thuscommunity-acquiredacquisitionofaninfectingstrainfrequentlymanifestsasinvasiveinfectionduringhospitalization,althoughnosocomialacquisitionisalsocommon.因此，社区获得性感染菌可能是早期入院期间获得的感染，虽然社会获得的可能性也存在acontaminatedairsource污染的空气Theprimaryriskfactors最主要的风险因素profoundneutropeniaandglucocorticoiduse严重的粒细胞缺乏或糖皮质激素使用riskincreaseswithlongerdurationoftheseconditions随着上述情况时间的延长，风险升高neutrophiland/orphagocytedysfunction中性粒细胞和/或巨噬细胞功能不全relapsedleukemia复发的白血病temporaryabrogationofprotectiveresponsesasaresultofglucocorticoiduseorageneralanti-inflammatorystateisasignificantriskfactor由于使用糖皮质激素或处于抗炎状态，使得机体保护反应暂时缺失，是（曲霉病）的危险因素priorpulmonarydisease既往肺部疾病sinusitis鼻窦炎Anti-tumornecrosisfactortherapyalsocarriesanincreasedriskofinfection抗肿瘤坏死因子的治疗也回提升感染的风险underlyingpulmonarydisease基础肺部疾病医学英文词汇小结-INFECTION15.7tuberculosis结核sarcoidosis结节病Glucocorticoidsacceleratediseaseprogression糖皮质激素加速病程进展Allergicbronchopulmonaryaspergillosis(ABPA)变应性支气管肺曲菌病Invasivepulmonaryaspergillosis侵袭性肺曲霉病InvasiveaspergillosisisarbitrarilydividedintoacuteandsubacuteformsthathavecoursesofW1monthand1-3months,respectively.侵袭性曲霉病主要分为急性型(病程＜1个月)和亚急性型(病程1-3月)。Themostcommonclinicalfeaturesarenosymptomsatall最主要的临床特征为没有症状fever,cough(sometimesproductive),nondescriptchestdiscomfort,trivialhemoptysis,andshortnessofbreath发热，咳嗽(有时有痰)，非典型胸部不适，轻微咯血，气短等Althoughthefeveroftenrespondstoglucocorticoids,thediseaseprogresses尽管可以应用糖皮质激素应对发热，但是疾病仍在进展urgentCTofthethorax迅速进行咽部CTrecipientsofhematopoieticstemcelltransplants造血干细胞移植患者themostcommonfeaturesarenasalorfacialdiscomfort,blockednose,andnasaldischarge(sometimesbloody)最常见的症状是鼻子和面部不适，鼻子不通气，鼻涕中带血Endoscopicexaminationofthenoserevealspale,duskyornecrotic-lookingtissueinanylocation鼻腔内镜检查可见苍白、尘状或坏死组织Tracheobronchitis气管支气管炎Theresultingmanifestationsrangefromacuteorchronicbronchitistoulcerativeorpseudomembranoustracheobronchitis临床表现可能为急慢性支气管炎，溃疡性气管支气管炎，假膜性气管支气管炎Obstructionwithmucousplugs粘液栓导致的梗阻Aspergillusdisseminatesfromthelungstomultipleorgans-mostoftentothebrainbutalsototheskin,thyroid,bone,kidney,liver,gastrointestinaltract,eye(endophthalmitis),andheartvalve曲霉可从肺部蔓延至不同的器官，最常见的为脑补，其次还可能侵及皮肤、甲状腺、骨骼、肾脏、肝、胃肠道、眼部(眼内炎)及心脏瓣膜gradualclinicaldeteriorationover1-3days在三天内逐渐恶化low-gradefever55.Invasivesinusitis 低热侵袭性鼻窦炎医学英文词汇小结-INFECTION15.7featuresofmildsepsis轻度脓毒病特征nonspecificabnormalitiesinlaboratorytests实验室检查有非典型性异常Inmostcases,atleastonelocalizationbecomesapparentbeforedeathoccurs在患者死亡前，可明确至少一个感染灶Bloodculturesarealmostalwaysnegative.血培养一般为阴性Cerebralaspergillosis脑曲霉病Hematogenousdisseminationtothebrainisadevastatingcomplicationofinvasiveaspergillosis侵袭性菌霉致病性并发症即血行传播至脑部Singleormultiplelesionsmaydevelop病发灶可单发或多发hemorrhagicinfarction出血性梗塞形成cerebralabscess脑部脓肿Rarermanifestationsincludemeningitis,mycoticaneurysm,andcerebralgranuloma脑膜炎、细菌性动脉瘤、脑肉芽肿较少出现cranialsinuses硬膜窦Postoperativeinfectionoccursrarelyandisexacerbatedbyglucocorticoids,whichareoftengivenafterneurosurgery术后感染较少出现，但术后常用糖皮质激素可加剧感染moodchanges脾气改变declineinmentalstatus精神状态下降Cerebralgranuloma脑肉芽肿mimicaprimaryorsecondarytumor表现像原发或继发肿瘤unenhancedCTofthebrainisusuallynonspecific脑部平扫的影响通常是非典型的contrastisoftencontraindicatedbecauseofpoorrenalfunction由于肾脏功能不全，造影剂禁用Endocarditis心内膜炎prostheticvalveinfectionsresultingfromcontaminationduringsurgery术中感染可导致人工瓣膜感染illicitIVdrugs非法药物Culture-negativeendocarditiswithlargevegetations巨大赘生物但是血培养可呈阴性的心内膜炎themostcommonpresentation最主要的表现embolectomyrevealsthediagnosisinafewcases某些情况下，栓子清除术可确定诊断医学英文词汇小结-INFECTION15.7anerythematousorpurplishnontenderarea红或紫，但无痛觉的部位anecroticeschar坏死的焦痂DirectinvasionoftheskinoccursinneutropenicpatientsatthesiteofIVcatheterinsertionandinburnpatients.直接侵犯皮肤发生在中性粒细胞缺乏患者静脉导管置入的部位，以及烧伤患者chroniccavitarypulmonaryaspergillosis(alsocalledsemi-invasiveaspergillosis,chronicnecrotizingaspergillosis,orcomplexaspergilloma)慢性空洞性肺曲霉病(又称半侵袭性曲霉病、慢性坏死性曲霉病、复杂曲霉菌)oneormorepulmonarycavitiesexpandingoveraperiodofmonthsoryearsinassociationwithpulmonarysymptomsandsystemicmanifestationssuchasfatigueandweightloss在数月或数年内，一个或多个肺部空洞形成，并伴有肺部症状或全身症状，如疲倦、体重下降hallmark特征Oftenmistakeninitiallyfortuberculosis常会误诊为结核atypicalmycobacterialinfection非典型分支杆菌感染pneumothorax气胸Theonsetisinsidious,andsystemicfeaturesmaybemoreprominentthanpulmonarysymptoms起病无典型症状，全身症状特征比肺部症状明显Cavitiesmayhaveafluidlevelorawell-formedfungalball空洞可有液平面，或出现形状规则的真菌球影pericavitaryinfiltratesandmultiplecavities—withorwithoutpleuralthickening—aretypical典型症状包括空洞周围有渗出，可伴随多个空洞，伴随或不伴随胸膜增厚IgGantibodies(usuallyprecipitating)toAspergillus曲霉菌的IgG抗体(沉淀法)concurrentinfections同时感染atypicalmycobacteriaand/orotherbacterialpathogens非典型分支杆菌和/或其他细菌类致病菌unilateralorupper-lobefibrosis单侧或肺上页纤维化Thisend-stageentityistermedchronicfibrosingpulmonaryaspergillosis晚期状态成为慢性纤维性肺曲霉病Aspergilloma(fungalball)曲霉肿(真菌球)Signsandsymptomsassociatedwithsingle(simple)aspergillomasareminor,includingacough(sometimesproductive),hemoptysis,wheezing,andmildfatigue.单发曲霉肿症状较轻微，包括咳嗽(可有痰)，咳血，哮鸣音，轻度疲倦ThevastmajorityoffungalballsarecausedbyA.fumigatus,butA.nigerhasbeenimplicated,particularlyindiabeticpatients医学英文词汇小结-INFECTION15.7大多数真菌灶是由烟曲霉造成的，但是对于糖尿病患者，黑曲霉的可能性也很大aspergillomasduetoA.nigercanleadtooxalosiswithrenaldysfunction黑曲霉感染科导致尿酸盐沉积，进而导致肾功能不全Themostsignificantcomplicationofaspergillomaislife-threateninghemoptysis,whichmaybethepresentingmanifestation曲霉感染最重要的并发症为致死性咯血Somefungalballsresolvespontaneously,butthecavitymaystillbeinfected某些情况下，真菌灶可吸收，但是空洞仍是感染状态Chronicsinusitis慢性鼻窦炎Threeentitiesaresubsumedunderthisbroadlabel:sinusaspergilloma,chronicinvasivesinusitis,andchronicgranulomatoussinusitis（慢性鼻窦炎）包括鼻窦曲霉肿、慢性侵袭性鼻窦炎、肉芽肿性鼻窦炎Allergicbronchopulmonaryaspergillosis（ABPA）representsahypersensitivityreactiontoA.fumigatus变应性支气管肺曲菌病表现为对烟曲霉的高敏感性116Eosinophilia嗜酸粒细胞增多elevatedserumleveloftotalIgE（usually>1000IU/mL）血清总IgE升高（通常>1000IU/mL）apositiveskin-pricktesttoA.fumigatusextract皮试对烟曲霉阳性detectionofAspergillus-specificIgEandIgG（precipitating）antibodies监测曲霉特异性IgE和IgG抗体Centralbronchiectasisischaracteristic中心性支气管扩张multiplecoursesofantibioticsthatareofonlylimitedbenefit多疗程抗菌药物使病人获益有限ThehistologichallmarkofallergicfungalsinusitisislocaleosinophiliaandCharcot-Leydencrystals（thebreakdownproductsofeosinophils）.过敏性真菌鼻窦炎的典型组织学特点是局部嗜酸粒细胞升高以及出现夏科-莱登结晶（嗜酸粒细胞的终产物）Aspergilluscancausekeratitisandotitisexterna曲霉可导致角膜炎和外耳炎Patientswithacuteinvasiveaspergillosishavearelativelyheavyloadoffungusintheaffectedorgan.Thusculture,moleculardiagnosis,antigendetection,andhistopathologyusuallyconfirmthediagnosis.急性侵袭性曲霉菌病通常在受累器官真菌负荷较重，因此，细菌培养，分子诊断，抗体检测以及组织病理学证据均可明确诊断However,thepaceofprogressionleavesonlyanarrowwindowformakingthediagnosiswithoutlosingthepatient,andsomeinvasiveproceduresarenotpossiblebecauseofcoagulopathy,respiratorycompromise,andotherfactors但是，疾病进展迅速，留给医师确诊及制定治疗方案的时间有限。某些情况下，由于合并凝血障碍，呼吸系统损伤，决策时间更为紧迫医学英文词汇小结-INFECTION15.7126.Aspergillushyphaearehyaline,narrow,andseptate,withbranchingat45°曲霉菌素为透明的，狭长的，具有膈膜分离的，分叉角度为45°些B内酰胺/B内酰胺酶抑制剂的患者134.Thesensitivityofantigendetectionisreducedbyantifungalprophylaxis预防性抗真菌治疗也可是抗原检测呈现127.Hyphaecanbeseenincytologyormicroscopypreparations,whichthereforeprovidearapidmeansofpresumptivediagnosis菌丝在细胞学检查或显微镜下.可见，可以快速指导诊断假阳性135.apositivecultureofasampletakendirectlyfromanordinarilysterilesite(e.g.,abrainabscess)原本无菌体液培养出的阳性菌(如脑脓肿)128.Bacterialagarislesssensitivethanfungalmediaforculture真菌培养基比细菌培养基更为敏感136.positiveresultsofbothhistologictestingandcultureofasampletakenfromanaffectedorgan组织学检查阳性以及病灶部位标本培养129.Culturemaybefalselypositive(e.g.,inpatientswhoseairwaysarecolonizedbyAspergillus)orfalselynegative真菌培养存在假阳性(如气道内定植)或假阴性阳性ground-glassappearance毛玻璃样Voriconazoleisthepreferredagentfor130.Moleculardiagnostictechniquesarefasterandmuchmoresensitivethancultureofrespiratorysamplesandblood分子诊断优于呼吸道标本及血标本培养，因为更快且敏感性更高invasiveaspergillosis侵袭性曲霉菌病首选药物为伏立康唑139.caspofungin,posaconazole,andlipid-associatedamphotericinBaresecond-lineagents131.TheAspergillusantigentestreliesondetectionofgalactomannanreleasefromAspergillusspp.duringgrowth曲霉菌抗原是检测曲霉属真菌在生长过程中释放的半乳甘露聚糖卡泊芬净、泊沙康唑以及两性霉素B为二线用药140.AmphotericinBisnotactiveagainstA.terreusorA.nidulans两性霉素B对土曲霉、构巢曲霉无效132.positiveresultsusuallyprecedeclinicalorradiologicfeaturesbyseveraldays阳性结果早于临床表现及影像学表现若干天141.Aninfectiousdiseaseconsultationisadvisedforpatientswithinvasivedisease,giventhecomplexityofmanagement由于治疗复杂，侵袭性曲霉菌病应进行会133.AntigentestingmaybefalselypositiveinpatientsreceivingcertainP-lactam/0-lactamaseinhibitorantibioticcombinations.某些患者抗原检测可呈假阳性，如接受某诊142.Itisnotclearwhethercombinationtherapyforacuteinvasiveaspergillosisisbeneficial,butitiswidelyusedforveryill医学英文词汇小结-INFECTION15.7patientsandforthosewithapoorprognosis.虽然联合用药是否能带来更多获益尚未达成共识，但是对于情况不佳及预后不良的患者，联合用药十分普遍patientsandforthosewithapoorprognosis.虽然联合用药是否能带来更多获益尚未达成共识，但是对于情况不佳及预后不良的患者，联合用药十分普遍Theinteractionsofvoriconazoleanditraconazolewithmanydrugsmustbeconsideredbeforetheseagentsareprescribed伏立康唑、伊曲康唑药物相互作用较多，临床使用应注意manyauthoritiesrecommendmonitoringtoensurethatdrugconcentrationsareadequatebutnotexcessive推荐应用TDM以防止药物过量Thedurationoftherapyforinvasiveaspergillosisvariesfrom-