Roque Jorge, Navarro Montserrat, Toro Gloria, González Isabel, Pimstein Milena, Venegas Eleonor
Unidad Cuidados Intensivos de Pediatría, Hospital San Juan de Dios, Santiago de Chile.
Rev Med Chil. 2003 Jan;131(1):77-80.
The incidence of systemic fungal infections increased during the last two decades. Rare fungi, such as Mucor, Fusarium and Paecilomyces, are emerging as causes of systemic fungal infections in immunocompromised hosts. There are reports of cutaneous infections, endophthalmitis, keratitis, sinusitis, neuropathy and fungemia in immunocompromised and immunocompetent adult patients. We report a 5 years old neutropenic patient with acute myeloid leukemia treated with multiple courses of chemotherapy, with a fungemia caused by Paecilomyces lilacinus (PL). His initial clinical course was characterized by fever, skin lesions, respiratory distress and shock. Blood and bone marrow cultures were positive. The patient was treated with amphotericin B and itraconazole with a good clinical response.
在过去二十年中，系统性真菌感染的发病率有所上升。罕见真菌，如毛霉、镰刀菌和拟青霉，正逐渐成为免疫功能低下宿主系统性真菌感染的病因。有报告称，免疫功能低下和免疫功能正常的成年患者出现了皮肤感染、眼内炎、角膜炎、鼻窦炎、神经病变和真菌血症。我们报告了一名5岁的急性髓系白血病中性粒细胞减少患者，该患者接受了多疗程化疗，发生了由淡紫拟青霉（PL）引起的真菌血症。他最初的临床病程表现为发热、皮肤病变、呼吸窘迫和休克。血液和骨髓培养呈阳性。该患者接受了两性霉素B和伊曲康唑治疗，临床反应良好。
