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一名急性白血病患者的热带念珠菌关节炎

Candida tropicalis arthritis in a patient with acute leukemia.

作者信息

Hu Xiao-Rong, He Jing-Song, Ye Xiu-Jin, Zheng Wei-Yan, Wu Wen-Jun, Lin Mao-Fang

机构信息

Bone Marrow Transplantation Center, The First Hospital, Zhejiang University Midical College, Hangzhou 310003, Zhejiang Province, China.

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2008 Oct;16(5):1215-8.

Abstract

Candida arthritis in patient with hematological malignancy is rare. A case of Candida tropicalis arthritis of knee occurred in a patient with acute monocytic leukemia was reported during the recovery phase of post chemotherapy myelosuppression and agranulocytosis. The patient was diagnosed as Candida tropicalis arthritis of knee according to the Candida tropicalis isolated from the synovial fluid. Itraconazole and amphotericin B were intravenously injected for therapy for 4 - 5 weeks based on the susceptibility test in vitro, which showed better efficacy. But the arthritis relapsed at 4 - 6 weeks after the drug withdrawal. The curative effect was found in patient after treatment with fluconazole injection and articular cavity douching with amphotericin B for 8 weeks. In conclusion, although Candida arthritis in patient with hematological malignancy is rare, it still occurred in the patient with hypoimmunity. The treatment emphasis showed be placed on the full dosage and full treatment course of antifungal agent.

摘要

血液系统恶性肿瘤患者发生念珠菌关节炎较为罕见。本文报道1例急性单核细胞白血病患者在化疗后骨髓抑制和粒细胞缺乏恢复期发生热带念珠菌性膝关节炎。根据从滑液中分离出的热带念珠菌,该患者被诊断为热带念珠菌性膝关节炎。根据体外药敏试验,静脉注射伊曲康唑和两性霉素B治疗4 - 5周,疗效较好。但停药后4 - 6周关节炎复发。经氟康唑注射液及两性霉素B关节腔冲洗治疗8周后患者病情好转。总之,血液系统恶性肿瘤患者念珠菌关节炎虽少见,但在免疫低下患者中仍可发生。治疗应强调抗真菌药物的足量和全程使用。

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