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一例接受鲁索利替尼治疗的慢性粒单核细胞白血病患者发生新型隐球菌感染伴致命性心包填塞:病例报告并复习真菌性心包炎

Fulminant Cryptococcus neoformans infection with fatal pericardial tamponade in a patient with chronic myelomonocytic leukaemia who was treated with ruxolitinib: Case report and review of fungal pericarditis.

机构信息

Department of Medicine, Baylor College of Medicine, Houston, TX, USA.

Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

出版信息

Mycoses. 2018 Apr;61(4):245-255. doi: 10.1111/myc.12735. Epub 2018 Jan 19.

Abstract

Cryptococcus neoformans is a saprophytic fungal pathogen that can cause serious illness in immune-compromised hosts and it presents with a wide variety of clinical symptoms. We present a fatal case of fulminant C. neoformans infection presenting as pericardial tamponade in a 71-year-old male with chronic myelomonocytic leukaemia undergoing chemotherapy with the JAK-STAT inhibitor ruxolitinib. We also review the published cases of fungal pericarditis/tamponade. In addition to illustrating an atypical presentation of C. neoformans, this case highlights the risk for opportunistic fungal infections in patients with haematological malignancies, especially the ones treated with small molecule kinase inhibitors.

摘要

新型隐球菌是一种腐生性真菌病原体,可导致免疫功能低下宿主发生严重疾病,并表现出多种临床症状。我们报告了一例 71 岁男性慢性髓单核细胞白血病患者的致死性新型隐球菌感染病例,该患者正在接受 JAK-STAT 抑制剂芦可替尼化疗,表现为暴发性心包填塞。我们还回顾了已发表的真菌性心包炎/填塞病例。除了说明新型隐球菌的非典型表现外,该病例还强调了血液恶性肿瘤患者,特别是接受小分子激酶抑制剂治疗的患者发生机会性真菌感染的风险。

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