Verdeguer A, Fernández J M, Esquembre C, Ferris J, Ruiz J G, Castel V
Pediatric Oncology Unit, Hospital Infantil La Fe, Valencia, Spain.
Cancer. 1990 Feb 15;65(4):874-7. doi: 10.1002/1097-0142(19900215)65:4<874::aid-cncr2820650408>3.0.co;2-z.
Three children with acute lymphoblastic leukemia developed disseminated fungal disease predominantly involving the liver and spleen. The three patients were undergoing induction chemotherapy and had neutropenia when they presented prolonged fever not responsive to antibiotics. Once neutropenia was recovered, hepatosplenomegaly leukocytosis, elevated serum alkaline phosphatase, and hypoechoic areas in the spleen and liver ultrasound were observed. All fungal blood cultures were negative, with the diagnosis being confirmed by histologic study. One of the patients died without achieving control of the candidiasis. The other two patients received prolonged antifungal treatment concurrently with chemotherapy and both are alive, one of them cured and in complete remission. The increasing frequency of this infection in recent years and the importance of a prompt and prolonged administration of antifungal therapy to obtain the cure are discussed.
三名急性淋巴细胞白血病患儿发生了主要累及肝脏和脾脏的播散性真菌病。这三名患者正在接受诱导化疗，出现长时间发热且对抗生素无反应时存在中性粒细胞减少。一旦中性粒细胞减少恢复，观察到肝脾肿大、白细胞增多、血清碱性磷酸酶升高以及脾脏和肝脏超声检查显示低回声区。所有真菌血培养均为阴性，组织学研究确诊了诊断。其中一名患者未控制念珠菌病而死亡。另外两名患者在化疗的同时接受了长时间的抗真菌治疗，两人均存活，其中一人治愈并完全缓解。讨论了近年来这种感染频率的增加以及及时和长时间给予抗真菌治疗以实现治愈的重要性。
