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慢性移植物抗宿主病中社区获得性播散性皮炎外瓶霉病合并坏死性筋膜炎

Community-acquired Disseminated Exophiala dermatitidis Mycosis with Necrotizing Fasciitis in Chronic Graft-versus-host Disease.

作者信息

Sato Eiichi, Togawa Atsushi, Masaki Michio, Shirahashi Akihiko, Kumagawa Midori, Kawano Yasumasa, Ishikura Hiroyasu, Yamashiro Yuri, Takagi Satoshi, To Hiromi, Kobata Katsumi, Takeshita Morishige, Kusaba Koji, Sueoka Eisaburo, Tamura Kazuo, Takamatsu Yasushi, Takata Tohru

机构信息

Division of Medical Oncology, Hematology, and Infectious Diseases, Department of Internal Medicine, Fukuoka University Hospital, Japan.

Department of Blood Transfusion, Fukuoka University Hospital, Japan.

出版信息

Intern Med. 2019 Mar 15;58(6):877-882. doi: 10.2169/internalmedicine.1706-18. Epub 2018 Nov 19.

DOI:10.2169/internalmedicine.1706-18
PMID:30449799
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6465022/
Abstract

We herein report a case of systemic phaeohyphomycosis by Exophiala dermatitidis (E. dermatitidis) with chronic graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (HSCT). The patient had been taking oral corticosteroids for years to control the GVHD. Yeast-like fungi were identified in a blood culture, so treatment with micafungin (150 mg/day) was begun, with no improvement. The patient passed away on hospital Day 12. A sequence analysis of rRNA revealed the isolate to be E. dermatitidis. This report brings attention to an emerging mycosis of community-acquired Exophiala species infection in the very-late phase after allogenic HSCT in patients with chronic GVHD.

摘要

我们在此报告1例异体造血干细胞移植（HSCT）后发生慢性移植物抗宿主病（GVHD）并由皮炎外瓶霉（E. dermatitidis）引起系统性暗色丝孢霉病的病例。该患者多年来一直口服皮质类固醇以控制GVHD。血培养中鉴定出酵母样真菌，因此开始用米卡芬净（150mg/天）治疗，但无改善。患者于住院第12天死亡。rRNA序列分析显示分离株为皮炎外瓶霉。本报告提醒人们注意在慢性GVHD患者异体HSCT极晚期出现的社区获得性外瓶霉属真菌感染这一新兴真菌病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf6c/6465022/ed6e02e5a86a/1349-7235-58-0877-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf6c/6465022/c1449d0733bb/1349-7235-58-0877-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf6c/6465022/9c29cf18ec72/1349-7235-58-0877-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf6c/6465022/ed6e02e5a86a/1349-7235-58-0877-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf6c/6465022/c1449d0733bb/1349-7235-58-0877-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf6c/6465022/9c29cf18ec72/1349-7235-58-0877-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf6c/6465022/ed6e02e5a86a/1349-7235-58-0877-g003.jpg

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A Case of Disseminated Infection with Skin Manifestation due to Non-neoformans and Non-gattii Cryptococcus in a Patient with Refractory Acute Myeloid Leukemia.一名难治性急性髓系白血病患者发生非新型隐球菌和非格特隐球菌所致播散性感染并伴有皮肤表现的病例
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Curr Opin Infect Dis. 2020 Apr;33(2):101-109. doi: 10.1097/QCO.0000000000000632.
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J Clin Microbiol. 2017 Apr;55(4):1162-1176. doi: 10.1128/JCM.02459-16. Epub 2017 Jan 25.
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Executive Summary of Japanese Domestic Guidelines for Management of Deep-seated Mycosis 2014.《2014年日本深部真菌病管理国内指南执行摘要》
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