Nishimori Makoto, Takahashi Toshio, Suzuki Eiko, Kodaka Taiichi, Hiramoto Nobuhiro, Itoh Kiminari, Tsunemine Hiroko, Yarita Kyoko, Kamei Katsuhiko, Takegawa Hiroshi, Takahashi Takayuki
Departments of Hematology Shinko Hospital, Kobe.
Med Mycol J. 2014;55(4):E63-70. doi: 10.3314/mmj.55.E63.
Scedosporium prolificans (S. prolificans) is a type of mold, which rarely affects immunocompromised people. We treated a 71-year-old woman with acute myeloid leukemia (AML-M5a) with low-dose cytarabine, acralubicin, and filgrastim as the induction therapy. On day 7 after the initiation of chemotherapy, she became febrile and agranulocytic, and developed anal pain ; therefore, we discontinued the chemotherapy on day 8. Broad-spectrum antibiotics, micafungin, and then liposomal amphotericin B were ineffective. The serum concentration of β-D-glucan was 525 pg/mL. She died of multiple organ failure on day 17. S. prolificans was detected from the blood culture on day 13. Physicians should consider Scedosporium spp. infection when principal antifungal agents are ineffective and fungal infection is strongly suspected.
多育赛多孢菌是一种霉菌，很少感染免疫功能低下的人群。我们用小剂量阿糖胞苷、阿克拉霉素和非格司亭对一名71岁的急性髓系白血病（AML-M5a）女性进行诱导治疗。化疗开始后第7天，她出现发热和粒细胞缺乏，并出现肛门疼痛；因此，我们在第8天停止了化疗。广谱抗生素、米卡芬净，然后是脂质体两性霉素B均无效。β-D-葡聚糖的血清浓度为525 pg/mL。她在第17天死于多器官功能衰竭。第13天血培养检测到多育赛多孢菌。当主要抗真菌药物无效且强烈怀疑真菌感染时，医生应考虑赛多孢菌属感染。
