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播散性脑曲霉病合并血栓性微血管病。

Disseminated cerebral aspergillosis complicated by thrombotic microangiopathy.

作者信息

Lester Robynn, Church Deirdre, Ambasta Anshula

机构信息

Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.

Department of Pathology & Laboratory Medicine and Medicine, University of Calgary, Calgary, Alberta, Canada.

出版信息

Med Mycol Case Rep. 2019 Jul 5;25:25-28. doi: 10.1016/j.mmcr.2019.07.002. eCollection 2019 Sep.

DOI:10.1016/j.mmcr.2019.07.002
PMID:31334000
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6620712/
Abstract

Invasive aspergillosis (IA) is a serious condition that can affect almost any organ. Cerebral aspergillosis itself is rapidly fatal without treatment. We report a case of disseminated cerebral IA in a patient exposed to cyclophosphamide, rituximab and prednisone. This case is unique because: 1) disseminated IA has not been described in anti-glomerular basement membrane glomerulonephritis; 2) IA led to thrombotic microangiopathy with normal ADAMTS13 and 3) voriconazole toxicity necessitated use of isavuconazole for IA treatment.

摘要

侵袭性曲霉病(IA)是一种严重疾病,几乎可累及任何器官。脑曲霉病若不治疗本身会迅速致命。我们报告一例暴露于环磷酰胺、利妥昔单抗和泼尼松的患者发生播散性脑IA的病例。该病例独特之处在于:1)抗肾小球基底膜肾小球肾炎中尚未描述过播散性IA;2)IA导致血栓性微血管病,而ADAMTS13正常;3)伏立康唑毒性使得必须使用艾沙康唑治疗IA。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3db2/6620712/dd79abaca2ce/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3db2/6620712/962e9ef96c93/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3db2/6620712/dd79abaca2ce/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3db2/6620712/962e9ef96c93/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3db2/6620712/dd79abaca2ce/gr2.jpg

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本文引用的文献

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2
Complement-mediated thrombotic microangiopathy secondary to sepsis-induced disseminated intravascular coagulation successfully treated with eculizumab: A case report.依库珠单抗成功治疗继发于脓毒症诱导的弥散性血管内凝血的补体介导血栓性微血管病:一例报告
Medicine (Baltimore). 2017 Feb;96(6):e6056. doi: 10.1097/MD.0000000000006056.
3
Practice Guidelines for the Diagnosis and Management of Aspergillosis: 2016 Update by the Infectious Diseases Society of America.
曲霉病诊断和管理实践指南:美国感染病学会2016年更新版
Clin Infect Dis. 2016 Aug 15;63(4):e1-e60. doi: 10.1093/cid/ciw326. Epub 2016 Jun 29.
4
Incidence and characteristics of invasive fungal diseases in allogeneic hematopoietic stem cell transplant recipients: a retrospective cohort study.异基因造血干细胞移植受者侵袭性真菌病的发病率及特征:一项回顾性队列研究
BMC Infect Dis. 2015 Dec 29;15:584. doi: 10.1186/s12879-015-1329-6.
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Correlation of Pain and Fluoride Concentration in Allogeneic Hematopoietic Stem Cell Transplant Recipients on Voriconazole.接受伏立康唑治疗的异基因造血干细胞移植受者疼痛与氟化物浓度的相关性
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Isavuconazole: A New Broad-Spectrum Triazole Antifungal Agent.伊曲康唑:一种新型广谱三唑类抗真菌药物。
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