Department of General Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1143, Japan.
J Infect Chemother. 2012 Jun;18(3):395-8. doi: 10.1007/s10156-011-0318-y. Epub 2011 Oct 12.
We report the case of a 63-year-old man who presented at our hospital after experiencing fever and dyspnea for more than 1 month. Because his general condition was deteriorating, he was referred to our intensive care unit. He needed critical care and was treated with vasopressors, artificial ventilation, and continuous hemodialysis. Considering his systemic condition, hematological malignancy was suspected. Bone marrow and skin biopsies were performed, and the condition was diagnosed as diffuse large B-cell lymphoma. On the 15th day, suspecting infectious lung disease, we performed bronchoscopy, which showed Rhizopus infection. Thus, the patient was administered high-dose liposomal amphotericin B (10 mg/kg) therapy. On the 54th day, he died of a massive pulmonary hemorrhage. Autopsy revealed mucormycosis infection in multiple organs, including the lungs and liver. Vigilance regarding possible mucormycosis infection is required, even after initial chemotherapy in patients whose bone marrow is significantly affected by lymphoma cells and leukemic changes.
我们报告了一例 63 岁男性病例，该患者因发热和呼吸困难超过 1 个月而到我院就诊。由于他的一般情况恶化，他被转至我们的重症监护病房。他需要重症监护，并接受了血管加压药、人工通气和持续血液透析治疗。鉴于他的全身状况，怀疑患有血液系统恶性肿瘤。进行了骨髓和皮肤活检，诊断为弥漫性大 B 细胞淋巴瘤。第 15 天，怀疑肺部感染性疾病，我们进行了支气管镜检查，显示为根霉菌感染。因此，给予患者高剂量脂质体两性霉素 B（10mg/kg）治疗。第 54 天，他因大量肺出血死亡。尸检显示多个器官（包括肺和肝）存在毛霉菌感染。即使在初始化疗后，对于骨髓受到淋巴瘤细胞和白血病改变明显影响的患者，也需要警惕可能的毛霉菌感染。
