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由……引起的播散性血管内感染 病例报告及文献综述

Disseminated Intravascular Infection Caused by Case Report and Review of the Literature.

作者信息

Lazarus Jacob E, Branda John A, Gandhi Ronak G, Barshak Miriam B, Zachary Kimon C, Barczak Amy K

机构信息

Massachusetts General Hospital, Boston, Massachusetts, USA.

Harvard Medical School, Boston, Massachusetts, USA.

出版信息

Open Forum Infect Dis. 2020 May 15;7(6):ofaa166. doi: 10.1093/ofid/ofaa166. eCollection 2020 Jun.

Abstract

is a ubiquitous environmental saprophyte with worldwide distribution. Commonly found in soil and decomposing organic material [1, 2], can also be isolated from drinking water [3] and indoor and outdoor air [4-6]. In immunocompetent hosts, has been reported as a cause of locally invasive disease including prosthetic valve endocarditis [7, 8], endophthalmitis [9, 10], rhinosinusitis [11, 12], and dialysis-associated peritonitis [13, 14]. In contrast, disseminated infections are more commonly reported in immunocompromised patients, including those with chronic granulomatous disease [15], solid malignancy [16], acute leukemia [17], lymphoma [18], multiple myeloma [19], and after stem cell transplant for myelodysplasia [20]. In 1 case series examining invasive infections by non- molds, was the most common cause after spp. [21]. Here, we present the case of an immunocompetent patient with extensive intravascular infection involving prosthetic material. We describe successful induction therapy with combination antifungals and extended suppression with posaconazole with clinical quiescence and eventual normalization of serum fungal biomarkers.

摘要

是一种广泛分布于全球环境中的腐生菌。常见于土壤和分解的有机物质中[1,2],也可从饮用水[3]以及室内外空气中分离得到[4 - 6]。在免疫功能正常的宿主中,已报道其可导致局部侵袭性疾病,包括人工瓣膜心内膜炎[7,8]、眼内炎[9,10]、鼻窦炎[11,12]以及透析相关腹膜炎[13,14]。相比之下,播散性感染在免疫功能低下的患者中更为常见,包括患有慢性肉芽肿病的患者[15]、实体恶性肿瘤患者[16]、急性白血病患者[17]、淋巴瘤患者[18]、多发性骨髓瘤患者[19]以及骨髓发育异常接受干细胞移植后的患者[以20]。在1个检查非霉菌引起的侵袭性感染的病例系列中,在 种之后, 是最常见的病因[21]。在此,我们报告1例免疫功能正常的患者发生涉及人工材料的广泛血管内感染的病例。我们描述了联合抗真菌药物的成功诱导治疗以及泊沙康唑的延长抑制治疗,临床症状缓解,血清真菌生物标志物最终恢复正常。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3aae/7314584/ed992c544bb2/ofaa166f0001.jpg

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