深部真菌感染 的诊断治疗,复旦大学华山医院抗生素研究所,Fungi can infect,深部真菌病,深部真菌病（systemic mycosis，deep mycosis）：真菌侵犯脏器、皮下组织、皮肤（除表皮外）、粘膜所致的感染浅部真菌病：真菌侵犯表皮、毛发、甲床（角质层）所致的感染,深部真菌感染的重要性,美国 真菌感染所致的死亡病例在感染病中占第7位 1992年因真菌感染死亡2300例 70%为念珠菌、曲霉和新型隐球菌 NNIS资料19921999年期间念珠菌菌血症占医院血行感染中的第4位,Candidemia,Top 10 Etiologies of Nosocomial Blood Isolates (SCOPE) 1995-1998,% of isolates,Edmond et al CID 1999,深部真菌感染呈持续增多趋势,Fridkin S,Jarvis W.Clin Mirobio Rev 1996,9(4): 499511,深部真菌感染呈持续增多趋势,Fridkin S,Jarvis W.Clin Mirobio Rev 1996,9(4): 499511,深部真菌感染呈持续增多趋势,Rees JR et al. CID 1998;27:113847,Trends in the Incidence of Documented Fungal Infections,1980,1981,1982,1983,1984,1985,1986,1987,1988,1989,1990,0,1,2,3,4,5,6,7,%,USA,GERMANY,Adapted data from Beck-Sague J Infect Dis 1993 and Groll et al. J Infect 1996,Incidence of Invasive Mycotic Infections in a General Population 1992-1993,No. of cases per million per year,CANDIDA speciesalbicansnon-albicansCRYPTOCOCCUSASPERGILLUSAgents ofZYGOMYCOSISMALASSEZIA FURFUR,73 37 3666121.74 days unexplained fever despite broad spectrum antibiotics,Graft versus host disease,3 weeks corticosteroids,T38 and: prior mycosis AIDS immunosuppressives 10 days neutropenia,