Janik-Moszant Anna, Matyl Aleksander, Rurańska Iwona, Machowska-Majchrzak Agnieszka, Kluczewska Ewa, Szczepański Tomasz
Department of Pediatric Hematology and Oncology, Medical University of Silesia, Zabrze, Poland.
Pol J Radiol. 2012 Jan;77(1):54-7. doi: 10.12659/pjr.882582.
Although the new intensive chemotherapeutic programs introduced recently into hematooncological therapies have led to a higher number of recoveries, persistent neutropenia favours the spread of severe infections, frequently fungal infections. Systemic fungal infections in patients treated for proliferative diseases of the hematopoietic system are characterised by a severe, progressing course and high morbidity.
We present a case report that demonstrates the diagnostic problem of lesions in the central nervous system which developed following the fourth block of chemotherapy in an eight-year-old boy treated for acute myeloid leukaemia. The risk factors, high values of the inflammatory parameters and imaging results enabled us to diagnose a fungal infection of the central nervous system.
A fast improvement in the clinical condition of the patient after the applied antifungal therapy and the regression of lesions in the central nervous system shown in the imaging studies confirmed our final diagnosis.
尽管近期血液肿瘤治疗中引入的新强化化疗方案已使康复人数增多,但持续性中性粒细胞减少会促使严重感染扩散,常见的是真菌感染。接受造血系统增殖性疾病治疗的患者发生的系统性真菌感染具有病情严重、进展性病程和高发病率的特点。
我们呈现一份病例报告,该报告展示了一名8岁急性髓系白血病男孩在接受第四轮化疗后发生的中枢神经系统病变的诊断难题。危险因素、炎症参数的高值以及影像学结果使我们能够诊断出中枢神经系统真菌感染。
应用抗真菌治疗后患者临床状况迅速改善,影像学研究显示中枢神经系统病变消退,证实了我们的最终诊断。