Heath Jessica L, Yin Dwight E, Wechsler Daniel S, Turner David A
Divisions of Pediatric Hematology-Oncology, Department of Pediatrics, Duke University Medical Center, Durham, NC 27710, USA.
J Pediatr Hematol Oncol. 2012 May;34(4):e161-3. doi: 10.1097/MPH.0b013e318236c502.
Disseminated cryptococcal infection is rarely reported in the setting of pediatric acute leukemia, despite the immunocompromised state of these patients. However, when present, disseminated cryptococcal infection poses treatment challenges and is associated with significant morbidity and mortality. Treatment of invasive fungal disease in a child with acute leukemia requires a delicate balance between antifungal and antineoplastic therapy. This balance is particularly important early in the course of leukemia, as both the underlying disease and overwhelming infection can be life threatening. We describe the successful management of life-threatening disseminated cryptococcosis in a child with acute lymphoblastic leukemia during induction therapy.
尽管小儿急性白血病患者处于免疫功能低下状态,但播散性隐球菌感染在该背景下的报道却很少。然而,一旦出现,播散性隐球菌感染会带来治疗挑战,并与显著的发病率和死亡率相关。治疗患有急性白血病的儿童的侵袭性真菌病需要在抗真菌治疗和抗肿瘤治疗之间达成微妙的平衡。这种平衡在白血病病程早期尤为重要,因为基础疾病和严重感染都可能危及生命。我们描述了一名急性淋巴细胞白血病患儿在诱导治疗期间成功治疗危及生命的播散性隐球菌病的情况。