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脂质体两性霉素 B 和手术联合治疗儿童急性早幼粒细胞白血病患者肺部利什曼原虫接合菌病:该患者接受泊沙康唑抗真菌预防治疗。

Liposomal amphotericin B and surgery as successful therapy for pulmonary Lichtheimia corymbifera zygomycosis in a pediatric patient with acute promyelocytic leukemia on antifungal prophylaxis with posaconazole.

机构信息

Centre of Hematology and Oncology, Children's Hospital, Vilnius University Hospital Santariskiu Clinics, Santariskiu street 4, LT-08406 Vilnius, Lithuania.

出版信息

Med Oncol. 2013 Mar;30(1):433. doi: 10.1007/s12032-012-0433-3. Epub 2013 Jan 10.

Abstract

Pulmonary zygomycosis, also referred to as mucormycosis, is a fungal infection of lungs caused by fungi of the order Mucorales in the class of Zygomycetes. It is usually associated with high morbidity and mortality. Here, we report the case of a 14-year-old girl with pediatric acute promyelocytic leukemia (APL) on antifungal prophylaxis with posaconazole, who developed pulmonary Lichtheimia corymbifera (formerly Absidia corymbifera) zygomycosis. She was successfully treated by means of liposomal amphotericin B (L-AmB) and surgery. To our knowledge, this is the first published report on pediatric APL and pulmonary zygomycosis in the English language literature. At present, the patient is in complete remission of her APL and without any signs of recurrence of zygomycosis. This report suggests that efficient diagnostics, increased physician awareness, and reliance on adjunctive surgical therapy can result in a favorable outcome of pulmonary zygomycosis in immunocompromised children with hematological malignancies.

摘要

肺接合菌病,也称毛霉病,是一种肺部真菌感染,由接合菌门毛霉目中的真菌引起。它通常与高发病率和死亡率相关。在这里,我们报告了一例 14 岁女孩的病例,该女孩患有儿童急性早幼粒细胞白血病(APL),接受泊沙康唑进行抗真菌预防,发生了肺光盖伞属(旧称犁头霉属)接合菌病。她成功地接受了脂质体两性霉素 B(L-AmB)和手术治疗。据我们所知,这是英语文献中首次发表的关于儿童 APL 和肺接合菌病的报告。目前,该患者的 APL 完全缓解,且无任何接合菌病复发的迹象。该报告表明,在患有血液恶性肿瘤的免疫功能低下的儿童中,通过有效的诊断、提高医生的认识并依赖辅助手术治疗,可以获得肺接合菌病的良好转归。

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