累及下肢肌肉与椎体的慢性播散性念珠菌病1例并文献复习

Chronic Disseminated Candidiasis Involving the Lower Limb Muscles and Vertebrae: A Case Report and Literature Review

摘要: 目的：报道本院2024年12月收治累及下肢肌肉与椎体的慢性播散性念珠菌病1例患者。方法：以“Chronic disseminated candidiasis”为关键词，在PUBMED上搜索2016年1月~2026年3月间的18篇病例报告共20例患者，总结其发病部位及治疗方案并复习文献。结果：发病部位包括：肝(12/20)、脾(9/20)、皮肤/肌肉(7/20)、肾(6/20)、中枢(4/20)、肺(3/20)、心脏(3/20)、眼(2/20)、骨骼(2/20)、淋巴结(2/20)、甲状腺(1/20)、十二指肠(1/20)、扁桃体(1/20)。1例患者死亡前尚未启动抗真菌治疗，其余19例患者均接受抗真菌药物治疗，10例单纯药物治疗，其中2例病人死亡，8例患者药物联合手术治疗，其中1例病人死亡。结论：慢性播散性念珠菌病的发病部位极少累及骨骼，当累及骨骼时病情隐匿，可能仅表现为发热及局部疼痛，缺乏诊断的特异性，早期的影像学检查对疾病的诊断具有指导意义。

Abstract: Objective: To report a case of chronic disseminated candidiasis involving the lower limb muscles and vertebral bodies admitted to our hospital in December 2024. Methods: Using “Chronic disseminated candidiasis” as the key word, 18 case reports of 20 patients from January 2016 to March 2026 were retrieved from PUBMED. The sites of onset and treatment regimens were summarized and the literature was reviewed. Results: The sites of onset included: liver (13/20), spleen (9/20), skin/muscle (8/20), kidney (7/20), lung (3/20), brain (3/20), heart (3/20), eye (2/20), bone (2/20), lymph node (2/20), thyroid (1/20), duodenum (1/20), and tonsil (1/20). One patient died before antifungal treatment was initiated, and the remaining 19 patients all received antifungal drug treatment. Among them, 10 patients received drug treatment alone, with 2 deaths, and 8 patients received drug treatment combined with surgery, with 1 death. Conclusion: In chronic disseminated candidiasis, skeletal involvement is extremely rare. When the skeleton is affected, the disease presents in an insidious manner, which may only manifest as fever and local pain, lacking diagnostic specificity. Early imaging examinations are of guiding significance for the clinical diagnosis of this disease.