出芽短梗霉是一种条件致病菌，属于腐生性暗色真菌，可累及全身多个系统，但出芽短梗霉引起的肺部感染相对少见。本文报道1例接受多线治疗的肺癌患者通过肺泡灌洗液宏基因组二代测序诊断为出芽短梗霉肺炎。该患者并无呼吸系统症状，仅在胸部CT复查时发现双肺散在磨玻璃影，同时双手皮肤可见暗红色皮疹。经过伏立康唑抗真菌治疗后，该患者双肺和手部病灶均明显好转。文献回顾表明，两性霉素B、伊曲康唑、伏立康唑、氟康唑、5-氟胞嘧啶和泊沙康唑对出芽短梗霉感染均有较好疗效，其中皮肤感染以伊曲康唑效果最佳。鉴于出芽短梗霉感染的罕见性，目前仍无统一的抗真菌治疗标准，因此本例的诊疗经过可为出芽短梗霉肺炎的诊治提供一定的参考价值。 Aureobasidium pullulans (A。pullulans) is a conditional pathogen belonging to saprophytic dark fungi， which can affect multiple systems in the body。However， pulmonary infections caused by A。 pullulans are relatively rare。This article reports a case of A。 pullulans pneumonia diagnosed through metagenomic next-generation sequencing of alveolar lavage fluid in a patient receiving multimodal therapy for lung cancer。The patient presented no respiratory symptoms， with only scattered ground glass opacities detected upon CT reexamination， along with dark red rashes visible on the skin of both hands。Following antifungal treatment with voriconazole， the lung and hand lesions of the patient both showed significant improvement。Literature review suggests that amphotericin B， itraconazole， voriconazole， fluconazole， 5-fluorocytosine， and posaconazole are all effective in treating A。 pullulans infections， with itraconazole most effective for skin infections。Given the rarity of A。 pullulans infections， there is currently no standardized antifungal treatment。Therefore， the diagnostic and therapeutic experience of this case may provide some reference value for the management of A。 pullulans pneumonia。
Voriconazole in the treatment of Aureobasidium pullulans pneumonia: One case report and literature review
Aureobasidium pullulans (A.pullulans) is a conditional pathogen belonging to saprophytic dark fungi, which can affect multiple systems in the body.However, pulmonary infections caused by A. pullulans are relatively rare.This article reports a case of A. pullulans pneumonia diagnosed through metagenomic next-generation sequencing of alveolar lavage fluid in a patient receiving multimodal therapy for lung cancer.The patient presented no respiratory symptoms, with only scattered ground glass opacities detected upon CT reexamination, along with dark red rashes visible on the skin of both hands.Following antifungal treatment with voriconazole, the lung and hand lesions of the patient both showed significant improvement.Literature review suggests that amphotericin B, itraconazole, voriconazole, fluconazole, 5-fluorocytosine, and posaconazole are all effective in treating A. pullulans infections, with itraconazole most effective for skin infections.Given the rarity of A. pullulans infections, there is currently no standardized antifungal treatment.Therefore, the diagnostic and therapeutic experience of this case may provide some reference value for the management of A. pullulans pneumonia.
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