Maloisel F, Dufour P, Waller J, Herbrecht R, Marcellin L, Koenig H, Liu K L, Weber J C, Bergerat J P, Oberling F
Service d'Onco-Hématologie, Hôpital de Hautepierre, CHU de Strasbourg, France.
Nouv Rev Fr Hematol (1978). 1991;33(4):311-5.
Cunninghamella bertholletiae is a fungus of the Zygomycetes class, Mucorales order. Only very few cases of disseminated infection have been reported. We observed a new case in a 19 years old man with severe aplastic anemia, due to pulmonary primoinfection and hematologic dissemination. This aplastic anemia failed to respond first to an antithymocyte globulin and steroid treatment and then to cyclosporine A. Deferoxamine was infused weekly to prevent iron overload. During a second antithymocyte globulin and steroid treatment, the patient developed bilateral pneumonia. Culture of the broncho-alveolar washing fluid established the diagnosis by isolation of C. bertholletiae. Despite amphotericin B and 5-fluorocytosine intravenous therapy, the patient died of disseminated infection six days after diagnosis, which was confirmed by necropsy. Underlying conditions, diagnosis and treatment are discussed, together with a review of the literature.
柏氏小克银汉霉是接合菌纲毛霉目真菌。仅报道过极少数播散性感染病例。我们观察到一名19岁重度再生障碍性贫血男性患者出现了新病例，病因是肺部原发性感染和血液播散。该再生障碍性贫血最初对抗胸腺细胞球蛋白和类固醇治疗无反应，随后对环孢素A也无反应。每周输注去铁胺以预防铁过载。在第二次抗胸腺细胞球蛋白和类固醇治疗期间，患者出现双侧肺炎。支气管肺泡灌洗液培养通过分离出柏氏小克银汉霉确诊。尽管给予了两性霉素B和5-氟胞嘧啶静脉治疗，患者在诊断后六天死于播散性感染，尸检证实了这一点。本文讨论了潜在疾病、诊断和治疗，并对相关文献进行了综述。
