一名白血病患者因双隔镰孢菌引起的播散性感染治疗成功。
Successful outcome of treatment of a disseminated infection due to Fusarium dimerum in a leukemia patient.
作者信息
Letscher-Bru Valérie, Campos France, Waller Jocelyn, Randriamahazaka Raoul, Candolfi Ermanno, Herbrecht Raoul
机构信息
Institut de Parasitologie et de Pathologie Tropicale, Faculté de Médecine, 67000 Strasbourg, France.
出版信息
J Clin Microbiol. 2002 Mar;40(3):1100-2. doi: 10.1128/JCM.40.3.1100-1102.2002.
Abstract
We report the first case of proven disseminated infection due to Fusarium dimerum associated with a favorable outcome in a patient with acute leukemia and prolonged neutropenia. The patient presented persistent fever, multiple necrotic skin lesions, and bilateral pneumopathy. F. dimerum was first isolated from three blood cultures and then from a skin biopsy and a mouth wash. Microscopy of positive blood cultures showed hyphae with phialides and few curved unicellular and some rare bicellular phialoconidia, permitting immediate presumptive identification of the genus FUSARIUM: The patient failed to respond to conventional amphotericin B but recovered after treatment was switched to amphotericin B-lipid complex and neutrophil recovery.
摘要
我们报告了首例经证实的由双隔镰孢菌引起的播散性感染病例，该病例发生在一名患有急性白血病且长期中性粒细胞减少的患者身上，最终预后良好。患者出现持续发热、多处坏死性皮肤病变及双侧肺部病变。双隔镰孢菌最初从三次血培养中分离出来，随后又从皮肤活检组织和漱口液中分离出来。阳性血培养物的显微镜检查显示有具瓶梗的菌丝，少量弯曲的单细胞及一些罕见的双细胞瓶梗分生孢子，这使得能够立即初步鉴定为镰孢菌属。该患者对传统两性霉素B治疗无反应，但在改用两性霉素B脂质复合物治疗且中性粒细胞恢复后康复。
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