以消化系统感染为主要表现的儿童播散性阿萨希毛孢子菌感染1例报告

doi:10.12372/jcp.2026.25e1032

摘要/Abstract

摘要：

阿萨希毛孢子菌作为条件致病性真菌，其侵袭性、播散性感染多发生于免疫功能低下者，累及消化系统患者较为少见。本文报道了1例罕见的发生在无基础疾病儿童，主要累及胃肠道、肝胆以及腹腔淋巴结的播散性阿萨希毛孢子菌感染病例，1例7岁6个月男性儿童，因“腹痛5个月，贫血伴间断发热3月余”入院。临床主要表现为腹痛、贫血及反复发热，影像学、内镜及病理检查提示感染累及肝胆、胃、十二指肠及肠系膜淋巴结，多种抗真菌治疗无效，最终经组织病原学宏基因检测明确阿萨希毛孢子菌感染，予泊沙康唑联合氟胞嘧啶抗真菌治疗好转。无基础疾病者阿萨希毛孢子菌播散性感染罕见，消化系统感染患者除发热外可有腹痛、黄疸表现，累及胃肠道者可合并贫血、体重下降，该病早期诊断困难、死亡率高，治疗首选伏立康唑，联合抗真菌治疗可提高其疗效。

关键词: 阿萨希毛孢子菌, 播散性感染, 儿童

Abstract:

As a conditional pathogenic fungus, invasive or disseminated Trichosporon asahii infection mostly occurs in immunodeficient patients, and cases involving the digestive system are relatively rare. This paper reports a rare case of disseminated Trichosporon asahii infection in a child without underlying diseases, mainly involving the gastrointestinal tract, liver and gallbladder, and abdominal lymph nodes. In October 2023, a 7-year-and-6-month-old male child was admitted to our hospital with "abdominal pain for 5 months, anemia accompanied by intermittent fever for more than 3 months". The main clinical manifestations were abdominal pain, anemia, and recurrent fever. Imaging, endoscopic, and pathological examinations indicated that the infection involved the liver and gallbladder, stomach, duodenum, and mesenteric lymph nodes. Multiple antifungal therapies were ineffective. Ultimately, Trichosporon asahii infection was confirmed by next-generation sequencing (NGS) of tissue pathogens. The patient's condition improved after receiving treatment with posaconazole and flucytosine. Patients without underlying diseases rarely develop disseminated Trichosporon asahii infections. In addition to fever, patients with digestive system infections may present with abdominal pain and jaundice. Those with gastrointestinal involvement may develop complications such as anemia and weight loss. Early diagnosis of this disease is difficult, and the mortality rate is high. Voriconazole is the first-choice treatment, and combination antifungal therapy can improve its efficacy.

Key words: Trichosporon asahii, disseminated infection, child

中图分类号:

沈一燚, 钱雪莹, 郑玉灿, 陆妍, 刘志峰, 张志华. 以消化系统感染为主要表现的儿童播散性阿萨希毛孢子菌感染1例报告[J]. 临床儿科杂志, 2026, 44(3): 252-257.

SHEN Yiyi, QIAN Xueying, ZHENG Yucan, LU Yan, LIU Zhifeng, ZHANG Zhihua. Disseminated Trichosporon asahii infection mainly manifested as digestive system infection of a child: a case report and literature review[J]. Journal of Clinical Pediatrics, 2026, 44(3): 252-257.

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种属	组织部位	序列数	相对丰度	覆盖度
阿萨希毛孢子菌	胃体	414	40.55%	0.08%
	十二指肠	120	6.83%	0.03%
	肠系膜淋巴结	2 371	99.16%	0.52%