Herbrecht R, Letscher-Bru V, Fohrer C, Campos F, Natarajan-Ame S, Zamfir A, Waller J
Département d'Hématologie et d'Oncologie, Hôpital de Hautepierre, Avenue Molière, 67098 Strasbourg, France.
Eur J Clin Microbiol Infect Dis. 2002 Nov;21(11):814-7. doi: 10.1007/s10096-002-0828-8. Epub 2002 Oct 31.
A severely neutropenic patient with chronic lymphocytic leukemia developed a diffuse bilateral pulmonary infection while receiving a therapeutic daily dosage of intravenous amphotericin B for Candida glabrata esophagitis. Computed tomography of the chest showed numerous lung nodules, ground glass areas and a pleural effusion. Biopsy of one nodule demonstrated hyaline septate hyphae. Multiple sputum cultures grew Acremonium strictum. Increasing the dose of amphotericin B and the addition of itraconazole did not resolve the infection. Change of treatment to posaconazole given orally at 200 mg four times/d resulted in progressive improvement leading finally to cure after 24 weeks of therapy. Treatment with posaconazole was clinically and biologically well tolerated.
一名患有慢性淋巴细胞白血病的严重中性粒细胞减少患者，在接受每日治疗剂量的静脉注射两性霉素B治疗光滑念珠菌食管炎时，发生了弥漫性双侧肺部感染。胸部计算机断层扫描显示有许多肺结节、磨玻璃样区域和胸腔积液。对一个结节进行活检显示有透明分隔菌丝。多次痰培养长出了紧密枝顶孢。增加两性霉素B的剂量并加用伊曲康唑未能解决感染问题。改为口服泊沙康唑，200mg，每日4次，病情逐渐改善，最终在治疗24周后治愈。泊沙康唑治疗在临床和生物学上耐受性良好。
