Veldman B A J, Verweij P E, Blijlevens N M A
Department of Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Neth J Med. 2006 Apr;64(4):127-9.
Blood stream infections caused by Candida glabrata are difficult to manage. We describe a patient who underwent an allogeneic peripheral stem cell transplantation for acute myeloid leukaemia. The patient developed C. glabrata fungaemia that was refractory to liposomal amphotericin B therapy. After changing the therapy to caspofungin, blood cultures became sterile within two days and the patient recovered clinically. The patient died shortly after due to graft-versus-host disease and at autopsy there was no evidence of residual or persistent Candida infection. Caspofungin was effective in liposomal amphotericin-B refractory C. glabrata fungaemia and proved to rapidly clear the infection. Treatment options for candidaemia are discussed.
光滑念珠菌引起的血流感染难以处理。我们描述了一名因急性髓系白血病接受异基因外周干细胞移植的患者。该患者发生了光滑念珠菌血症，对脂质体两性霉素B治疗无效。将治疗改为卡泊芬净后，血培养在两天内转阴，患者临床康复。患者随后不久因移植物抗宿主病死亡，尸检未发现残留或持续念珠菌感染的证据。卡泊芬净对脂质体两性霉素B难治的光滑念珠菌血症有效，并证明能迅速清除感染。本文讨论了念珠菌血症的治疗选择。
