佘丹阳各类肺真菌病鉴别诊断之浅见ppt课件.pptVIP

解放军总医院呼吸科 佘丹阳;现行诊断模式强调肺真菌病的共性;现行诊断模式无助于各类肺真菌病间的鉴别;鉴别各类肺真菌病的主要线索;鉴别诊断之宿主因素EORTC/MSG2008:Host factors for probable or possible IFD;免疫缺陷并非必不可少的宿主因素;三种常见肺真菌病患者的抗生素使用史;肺念珠菌病：体内留置导管更常见;酵母菌感染宿主因素;曲霉和接合菌感染的宿主因素;各类肺真菌病临床表现的差异;三种常见肺真菌病的临床症状比较;影像表现是鉴别各类肺真菌病最重要的临床依据;肺曲霉病的影像表现;肺曲霉病的肺部影像;不同类型肺曲霉病的典型影像;血管侵袭性IPA的影像改变:肺梗死样楔形实变影;血管侵袭性肺曲霉病:多发结节和空洞;气道播散性肺曲霉病:从细支气管炎到向心性实变;气道播散性肺曲霉病:非对称团片影和向心性实变;慢性坏死性肺曲霉病: 不规则厚壁空洞;慢性肺曲霉病：Ball hole sign;ABPA:中心性支气管扩张伴粘液栓形成;肺隐球菌病的影像表现;肺隐球菌病的肺部影像;免疫正常患者肺隐球菌病：孤立结节;男性，41岁,体检发现双下肺阴影结节影3年,抗生素治疗无效， 经皮穿刺活检证实为肺隐球菌病;免疫缺陷患者肺隐球菌病的多种影像表现;肺念珠菌病的影像表现;肺念珠菌病的肺部影像;白血病患者化疗后继发念珠菌肺炎;C albicans infection and subsequent diffuse alveolar damage in a 23-year-old man with neutropenia following hematopoietic stem cell transplantation.;Pneumonia due to C albicans in a 25-year-old man with acute myeloid leukemia and hematopoietic stem cell transplant.(a) Transverse thin-section (1-mm collimation) CT scan of the right lung shows multiple, scattered, and poorly defined centrilobular nodules of different sizes.;Pneumonia due to C albicans in a 45-year-old man who underwent hematopoietic stem cell transplantation.;Candida albicans infection in a 28-year-old man with acute myeloid leukemia and hematopoietic stem cell transplant.;肺毛霉病的影像表现;肺毛霉病：实变伴中心坏死或空洞形成;肺毛霉病:巨大空洞;肺毛霉病: 巨大空洞;肺毛霉病：多发结节（播散型感染）;肺孢子菌病的影像表现;伴有低氧血症的弥漫性肺浸润;肺孢子菌病：从磨玻璃样渗出到融合性实变;肺孢子菌病的CT表现;