Jain S, Tarai B, Tuli P, Das P
Department of Laboratory Medicine, Max Super Speciality Hospital, Patparganj, New Delhi, India.
Indian J Med Microbiol. 2015 Oct-Dec;33(4):599-600. doi: 10.4103/0255-0857.167324.
We report a case of unusual fungal sepsis of Alternaria alternata in a patient of acute lymphoblastic leukaemia in 62-year-old male who presented with complaints of 'off and on' fever with decreased oral intake. On evaluation, haemogram showed low platelet count and 68% blast cells in peripheral blood. On flow cytometry of peripheral blood, the gated blasts (approximately 55%) highly express CD45, CD10, CD19, CD22 and condition was diagnosed as acute lymphoblastic leukaemia. He was started on standard induction treatment along with supportive therapies. During the course of treatment, two sets of paired blood cultures were sent 48 h apart. All of blood cultures were done on Bac-T alert 3D system. All of them yielded fungus. The fungus was then grown on Sabouraud's Dextrose agar media. It was identified as A. alternata. The patient condition worsened and later had cardiac arrest in ICU and could not be revived.
我们报告了一例62岁男性急性淋巴细胞白血病患者发生的罕见链格孢菌真菌败血症病例，该患者主诉反复发热伴口腔摄入量减少。经评估，血常规显示血小板计数低，外周血中有68%的原始细胞。对外周血进行流式细胞术检测时，门控原始细胞（约55%）高表达CD45、CD10、CD19、CD22，该病情被诊断为急性淋巴细胞白血病。他开始接受标准诱导治疗及支持性治疗。在治疗过程中，每隔48小时送检两组配对的血培养样本。所有血培养均在Bac-T alert 3D系统上进行。所有样本均培养出真菌。然后将该真菌接种在沙氏葡萄糖琼脂培养基上。经鉴定为链格孢菌。患者病情恶化，随后在重症监护病房发生心脏骤停，未能复苏。
