Hu Jiang-Wei, Shu Xiang-Rong, Ren Jing, Yin Xiu-Yun, Jiang Min, Hu Liang-Ding, Zhang Bo, Chen Hu
Hematopoietic Stem Cell Transplantation Center of PLA, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2010 Oct;33(10):730-3.
To study Fusarium solani infection as a complication in patients after allogeneic hematopoietic stem cell transplantation and to discuss the diagnosis and appropriate therapy.
Symptoms, physical examination, laboratory tests, computed tomographic (CT) scans, treatments and outcomes of Fusarium solani infection in a patient with acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation were retrospectively analyzed, and related literatures reviewed.
The patient developed pulmonary infiltration and systemic multiple subcutaneous masses after allogeneic hematopoietic stem cell transplantation. Tissue biopsy smear showed a large number of hyphae and spores, and fungal culture grew Fusarium solani. The subcutaneous masses were incised and drained, while amphotericin B and voriconazole were administered, with granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) for hematopoietic recovery. The patient was discharge after full recovery.
Fusarium solani infection is a rare but fatal complication after allogeneic hematopoietic stem cell transplantation. Once the skin lesions or subcutaneous masses developed, tissue smear and culture should be done as soon as possible. Early diagnosis and effective treatment to recovery of the patient after allogeneic hematopoietic stem cell transplant. Moreover, the recovery of adequate neutrophil levels is the most important factor in the resolution of fusarial infection.
研究尖孢镰刀菌感染作为异基因造血干细胞移植后患者的一种并发症，并探讨其诊断及合适的治疗方法。
回顾性分析1例急性髓系白血病患者异基因造血干细胞移植后尖孢镰刀菌感染的症状、体格检查、实验室检查、计算机断层扫描（CT）结果、治疗及转归，并复习相关文献。
该患者异基因造血干细胞移植后出现肺部浸润及全身多发皮下肿块。组织活检涂片可见大量菌丝及孢子，真菌培养长出尖孢镰刀菌。皮下肿块切开引流，同时给予两性霉素B和伏立康唑治疗，并使用粒细胞集落刺激因子（G-CSF）和粒细胞-巨噬细胞集落刺激因子（GM-CSF）促进造血恢复。患者完全康复后出院。
尖孢镰刀菌感染是异基因造血干细胞移植后一种罕见但致命的并发症。一旦出现皮肤病变或皮下肿块，应尽早进行组织涂片和培养。早期诊断并有效治疗有助于异基因造血干细胞移植后患者的康复。此外，恢复足够的中性粒细胞水平是解决镰刀菌感染的最重要因素。
