Täger F Marlis, Zaror C Luis, Martínez D Pilar
Instituto de Pediatría, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile.
Rev Chilena Infectol. 2012 Feb;29(1):101-7. doi: 10.4067/S0716-10182012000100017. Epub 2012 Apr 10.
Mucormycosis is an increasingly emerging life-threatening infection and is an important cause of morbidity and mortality in patients with leukemia. We present the case of a 4-year-old boy with an acute lymphoblastic leukemia complicated by severe and prolonged neutropenia during induction chemotherapy, who developed cutaneous mucormycosis of the elbow. Direct microscopy with KOH and the histopathologic observation of the skin revealed fungal hyphae without septations. The cultures were positive for Rhizopus microsporus var oligosporus. The patient was treated succefully with amphotericin B during 40 days, surgical debridement and dermoepidermic graft. Early recognition and prompt intervention with combined medical and surgical treatment may improve the outcome. The most common management strategy in survivors involves a combination of antifungal therapy with amphotericin B and surgical debridement.
毛霉病是一种日益常见的危及生命的感染，是白血病患者发病和死亡的重要原因。我们报告一例4岁急性淋巴细胞白血病男孩，在诱导化疗期间并发严重且长期的中性粒细胞减少症，发生了肘部皮肤毛霉病。用氢氧化钾直接显微镜检查及皮肤组织病理学观察发现无分隔的真菌菌丝。培养结果显示少根根霉小孢变种阳性。该患者接受两性霉素B治疗40天、手术清创和真皮表皮移植后成功治愈。早期识别并通过药物和手术联合治疗迅速干预可能改善预后。幸存者最常见的治疗策略是两性霉素B抗真菌治疗与手术清创相结合。
