探讨构巢曲霉致肺曲霉病的临床及病原学特点。

收集首都医科大学宣武医院2017年1月2例住院慢性阻塞性肺疾病患者的病例信息，分析患者的临床资料和实验室对病原菌的分离鉴定并复习相关文献。

两例患者均有慢性阻塞性肺部疾病史及多种基础疾病，临床表现为发热、咳嗽、喘息等，胸部影像学显示肺部斑片状高密度影；实验室检测G试验和GM试验均为阳性；痰液直接涂片镜检可见隔菌丝，分支45°角，分离菌经质谱和测序分析确定为构巢曲霉。临床根据病原学结果改用伏立康唑治疗后患者症状及体征好转出院。

构巢曲霉致肺曲霉病相对少见，病原学诊断对临床早期有效治疗肺曲霉病很重要。

To investigate the charicteristics of clinic and pathogen of pulmonary aspergillosis caused by Aspergillus nidulans.

Data of two hospitalized patients with chronic obstructive pulmonary disease in Xuanwu Hospital of Capital Medical University in January 2017 were collected. The clinical and laboratory data of the two cases were analyzed, respectively. The isolation and identification of pathogenic fungus were determined, and the literature was reviewed.

Two patients both had a history of long-term chronic obstructive pulmonary disease and a variety of underlying diseases. Clinical manifestations were high fever, cough, wheezing and so on. Chest imaging showed that pulmonary patchy high-density shadow. The isolate was identified as Aspergillus nidulans by sequencing and matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS). Patients’ symptoms and signs improved after treatment by voriconazole.

Pulmonary aspergillosis caused by Aspergillus nidulans is relatively rare, and etiological diagnosis is important to early effective treatment.