Stanzani Marta, Vianelli Nicola, Bandini Giuseppe, Paolini Stefania, Arpinati Mario, Bonifazi Francesca, Giannini Benedetta, Agostinelli Claudio, Baccarani Michele, Ricci Paolo
Institute of Hematology and Clinical Oncology Seràgnoli, University of Bologna, Italy.
J Infect. 2006 Dec;53(6):e243-6. doi: 10.1016/j.jinf.2006.02.011. Epub 2006 Apr 11.
Fusarium is an opportunistic fungal pathogen which is emerging as a significant cause of morbidity and mortality in the immunocompromised host [Fleming RV, Walsh TJ, Anaissie EJ. Emerging and less common fungal pathogens. Infect Dis Clin North Am 2002;16:915-34]. This disease can be localized, focally invasive or disseminated, when two or more noncontiguous sites are involved. Therapeutic options are scarce and mortality reaches 80-90% in patients subjected to allogeneic hematopoietic stem cell transplant (allo-SCT) [Nucci M, Marr KA, Queiroz-Telles F, Martins CA, Trabasso P, Costa S, et al. Fusarium infection in hematopoietic stem cell transplant recipient. Clin Infect Dis 2004;1237-42]. We report a case of disseminated Fusariosis in a severe immunocompromised patient after allo-SCT that responded to treatment with the early combination of intravenous voriconazole and liposomal amphotericin B.
镰刀菌是一种机会性真菌病原体，正逐渐成为免疫功能低下宿主发病和死亡的重要原因[弗莱明RV，沃尔什TJ，阿奈西EJ。新出现和较少见的真菌病原体。北美传染病临床杂志2002；16：915 - 34]。当涉及两个或更多不相邻部位时，这种疾病可以是局限性、局灶性侵袭性或播散性的。治疗选择很少，接受异基因造血干细胞移植（allo - SCT）的患者死亡率达到80 - 90%[努奇M，马尔KA，奎罗斯 - 特莱斯F，马丁斯CA，特拉巴索P，科斯塔S等。造血干细胞移植受者的镰刀菌感染。临床传染病杂志2004；1237 - 42]。我们报告一例allo - SCT后严重免疫功能低下患者发生播散性镰刀菌病的病例，该病例对静脉注射伏立康唑和脂质体两性霉素B早期联合治疗有反应。
