狼疮肾炎并发肺部曲霉菌感染及脑膜炎一例暨文献复习

目的 通过报道1例典型的狼疮肾炎（LN）患者并发侵袭性真菌感染（IFI）的病例，并复习相关文献以期为临床提供早期诊治系统性红斑狼疮（SLE）患者并发IFI的依据和经验。 方法 描述患者发病及诊治经过，同时系统地回顾相关文献，分析总结SLE患者并发IFI的诊断方法、常见致病菌及易感因素。 结果 通过应用IFI诊断指南可以早期诊断SLE患者并发IFI，同时有效排除呼吸道定植等非侵袭性真菌感染，早期治疗，有利于提高该疾病的诊断率和治愈率。SLE患者并发IFI最常见的致病菌是隐球菌和曲霉菌，不是常见的白色念珠菌。SLE患者并发IFI的易感因素是狼疮活动和免疫抑制剂的应用。 结论 IFI 诊断指南对SLE并发IFI的诊断和治疗具有指导意义。SLE并发IFI的常见致病菌是隐球菌和曲霉菌，易感因素是狼疮活动和免疫抑制剂的应用。

Aspergillus pneumonia and meningitis in a patient with lupus nephritis: case report and literature review

Objective By reporting a fatal case of severe lupus nephritis (LN) complicated with invasive aspergillus pneumonia and meningitis and reviewing the associated literatures, to provide a way of early diagnosis and proper management for the patients suffering from systemic lupus erythematosus (SLE) and invasive fungus infection (IFI). Methods The onset, diagnosis and treatment course of the disease were described and associated literatures were reviewed to analyze and summary the diagnostic methods, common pathogenic bacteria and predisposing factors of SLE patients with IFI. Results Application of IFI guideline for cancer patients and those undergoing hematopoietic stem cell transplantation could be helpful in the early diagnosis and treatment of SLE patients complicated with IFI. The most common pathogen of SLE patient suffering from IFI was cryptococcus neoformans and aspergillus, not candida albicans. The main predisposing factors were high lupus activity and immunosuppressant. Conclusions Guideline of IFI for cancer patients and those undergoing hematopoietic stem cell transplantation is also helpful for the SLE patients complicated with IFI. The most common pathogens of IFI in SLE patients are cryptococcus neoformans and aspergillus. The predisposing factors are high lupus activity and immunosuppressant.