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成功治疗急性淋巴细胞白血病患者的双侧内源性茄病镰刀菌眼内炎。

Successful treatment of bilateral endogenous Fusarium solani endophthalmitis in a patient with acute lymphocytic leukaemia.

机构信息

Institute of Hematology "Lorenzo e Ariosto Seràgnoli", Department of Specialistic Diagnostic and Experimental Medicine (DIMES), Sant'Orsola-Malpighi Hospital Teaching Hospital, University of Bologna, Bologna, Italy.

Ophthalmology Unit, Department of Specialistic Diagnostic and Experimental Medicine (DIMES), Sant'Orsola-Malpighi Teaching Hospital, University of Bologna, Bologna, Italy.

出版信息

Mycoses. 2018 Jan;61(1):53-60. doi: 10.1111/myc.12697. Epub 2017 Sep 22.

Abstract

Fusarium spp. are an uncommon cause of fungaemia in immunocompromised and neutropenic patients that may hematogenously disseminate to the eyes. Herein, we describe a patient with acute lymphoblastic leukaemia and a prior history of extensive corticosteroid exposure who developed disseminated Fusarium solani infection following chemotherapy despite posaconazole prophylaxis. She was successfully treated with combination liposomal amphotericin B and voriconazole, intraocular injections of voriconazole, topical amphotericin B and bilateral vitrectomy. We also review published literature describing the management of endogenous Fusarium endophthalmitis in immunocompromised hosts.

摘要

镰刀菌属是免疫功能低下和中性粒细胞减少患者中一种不常见的真菌血症病原体,其可能经血源播散至眼部。在此,我们描述了一位患有急性淋巴细胞白血病且有广泛皮质类固醇暴露史的患者,尽管进行了泊沙康唑预防,但在化疗后仍发生了播散性茄病镰刀菌感染。她成功地接受了两性霉素 B 脂质体和伏立康唑联合治疗、玻璃体内注射伏立康唑、局部应用两性霉素 B 和双侧玻璃体切除术治疗。我们还回顾了描述免疫功能低下宿主内源性茄病镰刀菌眼内炎的管理的已发表文献。

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