東方伊蒙菌肺炎二例報告及文獻復習_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

熊六波 ^1,3 , 羅夢 ^2,4 , 王倩 ³ , 王戀 ³ , 顏浩 ³ ,  賀建清 ¹

1. ;
2. ;
3. ;
4. ;

Corresponding?author：

賀建清, Email: 18980602293@qq.com

Keywords：

東方伊蒙菌; 肺炎

DOI：

10.7507/1671-6205.202409088

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的東方伊蒙菌（又稱東方新興真菌）屬于伊蒙菌的一種菌屬，是一種雙向真菌，侵襲人類致肺炎罕見，常見于免疫低下人群，可導致患者呼吸衰竭危及生命。本文報道2例東方伊蒙菌肺炎患者。方法病例1：患者男，41歲，牧民，藏族，2020年4月就診，有腎移植病史，為牧人，有馬、羊、牛接觸史，長期服用他克莫司、嗎替麥考酚酯片。患者表現為咳嗽、胸痛1個月，胸部CT提示右肺下葉肺炎。支氣管肺泡灌洗液（bronchoalveolar lavage fluid，BALF）培養1周及BALF行宏基因組二代測序（metagenomics next-generation sequencing，mNGS）均查見東方伊蒙菌，住院期間背部皮膚出現潰瘍，分泌物培養查見東方伊蒙菌。給予泊沙康唑口服液治療14個月復查胸部CT提示感染病灶完全吸收，隨訪4年目前生存良好。病例2：患者男，36歲，職員，漢族，2024年1月就診，無免疫功能受損等基礎疾病。患者表現為胸痛1個月，胸部CT提示左下肺肺炎，BALF行mNGS提示東方伊蒙菌。給予兩性霉素B脂質體治療1個月后胸痛減輕，復查胸部CT提示感染病灶完全吸收。隨訪至今無復發。結果東方伊蒙菌感染人群可表現為肺內及肺外癥狀，檢查方法主要依靠病原菌培養及mNGS，免疫受損患者抗感染療程長，免疫正常患者抗感染療程根據病情可適當縮短。其治療藥物可選擇兩性霉素及唑類。結論東方伊蒙菌發病罕見，易誤診或漏診，抗感染治療無效時，尤其合并免疫抑制人群，臨床醫生應提高對東方伊蒙菌的警惕，早期診斷和治療可減少死亡及改善預后。

Citation： 熊六波, 羅夢, 王倩, 王戀, 顏浩, 賀建清. 東方伊蒙菌肺炎二例報告及文獻復習. Chinese Journal of Respiratory and Critical Care Medicine, 2025, 24(5): 356-360. doi: 10.7507/1671-6205.202409088 Copy

1.	Kenyon C, Corcoran C, Govender NP. An emmonsia species causing disseminated infection in South Africa. N Engl J Med, 2014, 370(3): 284. DOI: 10.1056/NEJMc 1314277.
2.	Jiang YP, Dukik k, Munoz JF, et al. Phylogeny, ecology and taxonomy of systemic pathogens and their relatives in Ajellomycetaceae (Onygenales): Blastomyces, Emergomyces, Emmonsia, Emmonsiellopsis. Fungal Diversity, 2018, 90: 245-291.
3.	Wang P, Kenyon C, de Hoog S, et al. A novel dimorphic pathogen, Emergomyces orientalis (Onygenales), agent of disseminated infection. Mycoses, 2017, 60(5): 310-319.
4.	馮佩英, 陸春. 伊蒙菌病與不育大孢子菌病. 中國真菌學雜志, 2015, 10(4): 245-248.
5.	Dukik K, Mu?oz JF, Jiang YP, et al. Novel taxa of thermally dimorphic systemic pathogens in the Ajellomycetaceae (Onygenales). Mycoses, 2017, 60(5): 296-309.
6.	Schwartz IS, Govender NP, Sigler L, et al. Emergomyces: The global rise of new dimorphic fungal pathogens. PLoS Pathog, 2019, 15(9): e1007977.
7.	Govender NP, Grayson W. Emergomycosis (Emergomyces africanus) in advanced HIV disease. Dermatopathology (Basel), 2019, 6(2): 63-69.
8.	楊英. 新發及罕見侵襲性真菌病原體的基因組研究及分子診斷. 解放軍軍事醫學科學院;中國人民解放軍軍事醫學科學院, 2017.
9.	Ibe C, Mnyambwa NP, Mfinanga SG, et al. Emergomycosis in Africa: time to pay attention to this emerging deadly fungal infection. Int j Gen Med, 2023, 16: 2313-2322.
10.	Thompson GR 3rd, Le T, Chindamporn A, et al. Global guideline for the diagnosis and management of the endemic mycoses: an initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology. Lancet Infect Dis, 2021, 21(12): e364-e374.
11.	Schwartz IS, Kenyon C, Lehloenya R, et al. AIDS-Related endemic mycoses in Western Cape, South Africa, and clinical mimics: a cross-sectional study of adults with advanced HIV and recent-onset, widespread skin lesions. Open Forum Infect Dis, 2017, 4(4): ofx186.
12.	Reddy DL, Nel J, Govender NP. Review: emergomycosis. J Mycol Med, 2023, 33(1): 101313.
13.	Schwartz IS, Sanche S, Wiederhold NP, et al. Emergomyces canadensis, a dimorphic fungus causing fatal systemic human disease in North Americas. Emerg Infect Dis, 2018, 24(4): 758-761.
14.	He D, Quan M, Zhong H, et al. Emergomyces orientalis emergomycosis by metgagenomic next-generation sequencing. Emerg Infect Dis, 2021, 27(10): 2740-2742.
15.	中國藥師協會, 中華醫學會細菌感染與耐藥防治學會, 國家衛生健康委臨床抗微生物藥物敏感性折點研究和標準制定專家委員會. 病原宏基因組高通量測序臨床本地化檢測規范專家共識. 中華預防醫學雜志, 2024, 58(4): 454-465.
16.	Gast KB, Van der Hoeven A, de Boer MGJ, et al. Two cases of Emergomyces pasteurianus infection in immunocompromised patients in the Netherlands. Med Mycol Case Rep, 2019, 24: 5-8.
17.	Capoor MR, Mishra N, Kolte S, et al. Disseminated Emergomyces pasteurianus infection in India: a case report and review. Mycopathologia, 2020, 185(1): 193-200.
18.	Chik KK, To WK. Autochthonous Emergomyces pasteurianus pneumonia in an immunocompromised patient in Hong Kong: a case report. Hong Kong Med J, 2020, 26(5): 446-448.
19.	Pierce J, Sayeed S, Doern CD, et al. Emergomyces pasteurianus in man returning to the United States from Liberia and review of the literature. Emerg Infect Dis, 2023, 29(3): 635-639.
20.	Machiavello Roman FJ, Pischel L, Azar MM. Lung infections due to emerging fungal pathogens. Curr Opin Pulm Med, 2024, 30(3): 258-265.
21.	Vinayagamoorthy k, Gangavaram DR, Skiada A, et al. Emergomycosis, an Emerging thermally dimorphic fungal infection: a systematic review. J Fungi(Basel), 2023, 9(10): 1039.
22.	H?ft MA, Duvenage L, Salie S, et al. The pathogenesis of experimental Emergomycosis in mice. PLoS Negl Trop Dis, 2024, 18(1): e0011850.
23.	夏宇, 考吾沙爾·巴合提江. 應用宏基因組二代測序技術分析慢性阻賽性肺疾病患者合并下呼吸道感染的BALF中微生物群落分布和載量. 中國呼吸與危重癥監護雜志, 2024, 23(6): 414-422.
24.	Samaddar A, Sharma A. Emergomycosis, an emerging systemic mycosis in immunocompromised patients: current trends and future prospects. Front Med (Lausanne), 2021, 8: 670731.

1. Kenyon C, Corcoran C, Govender NP. An emmonsia species causing disseminated infection in South Africa. N Engl J Med, 2014, 370(3): 284. DOI: 10.1056/NEJMc 1314277.
2. Jiang YP, Dukik k, Munoz JF, et al. Phylogeny, ecology and taxonomy of systemic pathogens and their relatives in Ajellomycetaceae (Onygenales): Blastomyces, Emergomyces, Emmonsia, Emmonsiellopsis. Fungal Diversity, 2018, 90: 245-291.
3. Wang P, Kenyon C, de Hoog S, et al. A novel dimorphic pathogen, Emergomyces orientalis (Onygenales), agent of disseminated infection. Mycoses, 2017, 60(5): 310-319.
4. 馮佩英, 陸春. 伊蒙菌病與不育大孢子菌病. 中國真菌學雜志, 2015, 10(4): 245-248.
5. Dukik K, Mu?oz JF, Jiang YP, et al. Novel taxa of thermally dimorphic systemic pathogens in the Ajellomycetaceae (Onygenales). Mycoses, 2017, 60(5): 296-309.
6. Schwartz IS, Govender NP, Sigler L, et al. Emergomyces: The global rise of new dimorphic fungal pathogens. PLoS Pathog, 2019, 15(9): e1007977.
7. Govender NP, Grayson W. Emergomycosis (Emergomyces africanus) in advanced HIV disease. Dermatopathology (Basel), 2019, 6(2): 63-69.
8. 楊英. 新發及罕見侵襲性真菌病原體的基因組研究及分子診斷. 解放軍軍事醫學科學院;中國人民解放軍軍事醫學科學院, 2017.
9. Ibe C, Mnyambwa NP, Mfinanga SG, et al. Emergomycosis in Africa: time to pay attention to this emerging deadly fungal infection. Int j Gen Med, 2023, 16: 2313-2322.
10. Thompson GR 3rd, Le T, Chindamporn A, et al. Global guideline for the diagnosis and management of the endemic mycoses: an initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology. Lancet Infect Dis, 2021, 21(12): e364-e374.
11. Schwartz IS, Kenyon C, Lehloenya R, et al. AIDS-Related endemic mycoses in Western Cape, South Africa, and clinical mimics: a cross-sectional study of adults with advanced HIV and recent-onset, widespread skin lesions. Open Forum Infect Dis, 2017, 4(4): ofx186.
12. Reddy DL, Nel J, Govender NP. Review: emergomycosis. J Mycol Med, 2023, 33(1): 101313.
13. Schwartz IS, Sanche S, Wiederhold NP, et al. Emergomyces canadensis, a dimorphic fungus causing fatal systemic human disease in North Americas. Emerg Infect Dis, 2018, 24(4): 758-761.
14. He D, Quan M, Zhong H, et al. Emergomyces orientalis emergomycosis by metgagenomic next-generation sequencing. Emerg Infect Dis, 2021, 27(10): 2740-2742.
15. 中國藥師協會, 中華醫學會細菌感染與耐藥防治學會, 國家衛生健康委臨床抗微生物藥物敏感性折點研究和標準制定專家委員會. 病原宏基因組高通量測序臨床本地化檢測規范專家共識. 中華預防醫學雜志, 2024, 58(4): 454-465.
16. Gast KB, Van der Hoeven A, de Boer MGJ, et al. Two cases of Emergomyces pasteurianus infection in immunocompromised patients in the Netherlands. Med Mycol Case Rep, 2019, 24: 5-8.
17. Capoor MR, Mishra N, Kolte S, et al. Disseminated Emergomyces pasteurianus infection in India: a case report and review. Mycopathologia, 2020, 185(1): 193-200.
18. Chik KK, To WK. Autochthonous Emergomyces pasteurianus pneumonia in an immunocompromised patient in Hong Kong: a case report. Hong Kong Med J, 2020, 26(5): 446-448.
19. Pierce J, Sayeed S, Doern CD, et al. Emergomyces pasteurianus in man returning to the United States from Liberia and review of the literature. Emerg Infect Dis, 2023, 29(3): 635-639.
20. Machiavello Roman FJ, Pischel L, Azar MM. Lung infections due to emerging fungal pathogens. Curr Opin Pulm Med, 2024, 30(3): 258-265.
21. Vinayagamoorthy k, Gangavaram DR, Skiada A, et al. Emergomycosis, an Emerging thermally dimorphic fungal infection: a systematic review. J Fungi(Basel), 2023, 9(10): 1039.
22. H?ft MA, Duvenage L, Salie S, et al. The pathogenesis of experimental Emergomycosis in mice. PLoS Negl Trop Dis, 2024, 18(1): e0011850.
23. 夏宇, 考吾沙爾·巴合提江. 應用宏基因組二代測序技術分析慢性阻賽性肺疾病患者合并下呼吸道感染的BALF中微生物群落分布和載量. 中國呼吸與危重癥監護雜志, 2024, 23(6): 414-422.
24. Samaddar A, Sharma A. Emergomycosis, an emerging systemic mycosis in immunocompromised patients: current trends and future prospects. Front Med (Lausanne), 2021, 8: 670731.

Previous Article
以多顱神經病變起病繼發多器官受累的結節病一例
Next Article
慢性阻塞性肺疾病患者吸氣峰流速影響因素的研究進展

Chinese Journal of Respiratory and Critical Care Medicine

東方伊蒙菌肺炎二例報告及文獻復習

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content