小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 发热
其他诊断因素
- 心动过速
- 呼吸急促
- 低血压
- 低毛细血管再灌注
- 急性精神错乱
- 排尿量减少
- 低血氧饱和度
- 皮疹
- 肝脾肿大
- 体温过低
危险因素
- 中心静脉导管的使用
- 广谱抗生素的使用
- 血液透析
- 手术
- 胃肠外营养
- 免疫抑制剂（例如，化疗、全身用皮质类固醇、生物制剂和其他免疫抑制剂）
- 多部位定植
- 静脉毒品使用
诊断性检查
首要检查
- 血液培养
- 全血细胞计数（FBC）
- 动脉血气分析（ABG）
- 乳酸水平
- 凝血功能检查
- 肾功能检查
- 肝功能检查
- 血清葡萄糖
需考虑的检查
- 1,3-β-D-葡聚糖
- T2 磁共振分析
- 组织活检
新兴检查
- 聚合酶链反应
- 基质辅助激光解吸电离飞行时间（MALDI-TOF）质谱分析
治疗流程
疑似诊断
确诊：非中性粒细胞减少患者（无并发症）
确诊：中性粒细胞减少（无并发症）
确诊：有并发症
撰稿人
作者
Brenda L. Tesini, MD
Assistant Professor
Infectious Diseases
Departments of Medicine and Pediatrics
University of Rochester Medical Center
Rochester
NY
利益声明
BLT has received honoraria from Merck for educational contributions unrelated to this topic.
鸣谢
Dr Brenda L. Tesini would like to gratefully acknowledge Dr Jack D. Sobel and Dr Sanjay G. Revankar, previous contributors to this topic.
利益声明
JDS declares that he has no competing interests. SR has received grants for research from Astellas, Gilead, and Merck, and has been involved in clinical trials for Cidara and Astellas.
同行评议者
John Fisher, MD
Professor of Medicine
Department of Medicine
Medical College of Georgia
Augusta
GA
利益声明
JF is an author of a number of references cited in this topic. JF is a member of the speaker's bureau for the following companies: Pfizer, Merck, and Astellas.
Jean-Michel Livrozet, MD
Praticien hospitalier
Service de medecine de la Transplantation et d'Immunologie clinique
Hopital Edouard Herriot
Lyon
France
利益声明
JML has been invited by Astellas, the manufacturer of micafungin, to attend a symposium, and invited by Gilead Sciences, manufacturer of liposomal amphotericin B, to attend different HIV conferences, and has been paid by Gilead Sciences for running HIV educational programs.
Matthew Falagas, MD, MSc, DSc
Director
Alfa Institute of Biomedical Sciences
Marousi
Athens
Greece
利益声明
MF declares that he has no competing interests.
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