Tuysuz Gulen, Ozdemir Nihal, Senyuz Osman Faruk, Emre Senol, Kantarcioglu Serda, Adaletli Ibrahim, Kepil Nuray, Tutuncu Cigdem, Celkan Tiraje
Pediatric Hematology Oncology Department, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
Mycoses. 2014 Aug;57(8):513-8. doi: 10.1111/myc.12184. Epub 2014 Mar 18.
We present a case of hepatic mucormycosis in a 9-year-old boy with acute lymphoblastic leukaemia. Despite long-term use of combined liposomal amphotericin B and posaconazole therapy, the lesion persisted and could only be treated by surgical excision. After surgery, antifungal treatment was continued with posaconazole. On follow-up, the patient had two episodes of ascending cholangitis which were responsive to intravenous antibiotics. He is doing well at the moment in remission for 2.5 years. Mucormycosis was long regarded as a fatal infection with poor prognosis. With early medical and surgical management, survival rates increase. Isolated hepatic mucormycosis is rare and only seven cases were reported in the literature up to now. We wanted to emphasise the role of early surgery in patients with hepatic mucormycosis in view of the literature.
我们报告一例9岁急性淋巴细胞白血病男孩发生肝毛霉菌病的病例。尽管长期联合使用脂质体两性霉素B和泊沙康唑治疗，但病变持续存在，只能通过手术切除进行治疗。术后，继续使用泊沙康唑进行抗真菌治疗。随访期间，患者发生了两次上行性胆管炎，静脉使用抗生素治疗有效。目前患者病情良好，已缓解2.5年。毛霉菌病长期以来被认为是一种预后不良的致命感染。通过早期药物和手术治疗，生存率会提高。孤立性肝毛霉菌病罕见，截至目前文献中仅报道过7例。鉴于文献报道，我们想强调早期手术在肝毛霉菌病患者中的作用。
