Department of Internal Medicine, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
J Mycol Med. 2018 Sep;28(3):527-530. doi: 10.1016/j.mycmed.2018.05.008. Epub 2018 May 26.
The patients with hematologic malignancies and hematopoietic stem cell transplantation (HSCT) recipients are at high risk for invasive fungal diseases (IFDs) mainly due to the severe and prolonged neutropenia related to high-dose chemotherapy. Voriconazole prophylaxis is recommended for possible IFDs. Mucormycosis is a fulminant infection, which may occur after voriconazole prophylaxis for invasive aspergillosis in immunocompromised hosts. Here, we report mucormycosis after 4 months of voriconazole prophylaxis in a young patient with relapsed acute lymphoblastic leukemia and hematopoietic stem cell transplant failure and discuss the clinical manifestation, imaging, laboratory findings and therapeutic regimens. Clinician's awareness of this entity and timely diagnosis using conventional and molecular methods are the promising approach for the management of this devastating infection.
血液系统恶性肿瘤和造血干细胞移植(HSCT)受者的患者有发生侵袭性真菌病(IFD)的高风险,主要是由于高强度化疗导致的严重和长期中性粒细胞减少。建议对可能发生的 IFD 进行伏立康唑预防。毛霉菌病是一种暴发性感染,可能在免疫功能低下宿主中使用伏立康唑预防侵袭性曲霉菌病后发生。在此,我们报告了一例复发性急性淋巴细胞白血病和造血干细胞移植失败的年轻患者在使用伏立康唑预防 4 个月后发生毛霉菌病,并讨论了其临床表现、影像学、实验室检查结果和治疗方案。临床医生对这种疾病的认识,以及使用常规和分子方法进行及时诊断,是管理这种破坏性感染的有前途的方法。