Mousset S, Bug G, Heinz W J, Tintelnot K, Rickerts V
Medizinische Klinik II, Klinikum der J.W. Goethe-Universität, Frankfurt am Main, Germany.
Transpl Infect Dis. 2010 Jun;12(3):261-4. doi: 10.1111/j.1399-3062.2009.00479.x. Epub 2009 Nov 30.
Antifungal prophylaxis with posaconazole (POS) has been shown to decrease the mortality associated with invasive fungal infections in high-risk patients. We report on a patient, with severe graft-versus-host disease after allogeneic stem cell transplantation, who developed proven pneumonia due to Rhizopus microsporus after 40 days of POS prophylaxis (fasting serum levels: 691-904 ng/mL). Despite combination treatment with liposomal amphotericin B and POS for 39 days, the patient died from pulmonary hemorrhage. This case highlights the need for continued awareness of breakthrough zygomycosis in patients receiving POS.
泊沙康唑（POS）预防性抗真菌治疗已被证明可降低高危患者侵袭性真菌感染相关的死亡率。我们报告了1例异基因干细胞移植后发生严重移植物抗宿主病的患者，该患者在接受POS预防性治疗40天后（空腹血清水平：691 - 904 ng/mL）确诊为微小根霉所致肺炎。尽管联合应用脂质体两性霉素B和POS治疗39天，患者仍死于肺出血。该病例凸显了对接受POS治疗患者的毛霉病突破性感染需持续保持警惕。
