Chen Youfei
Department of Respiratory Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
SAGE Open Med Case Rep. 2020 Jul 2;8:2050313X20938242. doi: 10.1177/2050313X20938242. eCollection 2020.
infection is an endemic opportunistic infection for immunodepression patients, especially HIV-positive patients. Our case describes an unendemic and HIV-negative patient who presented with fever, subcutaneous mass, osteolytic destruction of the skull and subcutaneous abscess penetrating the diseased skull. The growth of was identified by the culture of the frontal pus, sputum, blood and bone marrow. Due to severe nausea and vomiting during the use of amphotericin B, voriconazole was finally selected for treatment. Two weeks after intravenous infusion of voriconazole injection, the patient was given oral voriconazole tablets for 5 months. After the initial intravenous treatment of voriconazole, the patient developed increased dyspnea and required ventilator support with endotracheal intubation, and methylprednisolone was given intravenously for 5 days. All lesions absorbed and no obvious discomfort was found during the follow-up at the third month after discharge. At present, the patient has been followed up for more than 3 years without recurrence. The case aims to raise doctors' awareness of this rare disease in non-endemic areas and HIV-negative patients.
感染是免疫抑制患者的一种地方性机会性感染，尤其是艾滋病毒阳性患者。我们的病例描述了一名非地方性且艾滋病毒阴性的患者，该患者出现发热、皮下肿块、颅骨溶骨性破坏以及穿透病变颅骨的皮下脓肿。通过对额部脓液、痰液、血液和骨髓进行培养，确定了[病原体名称未给出]的生长。由于使用两性霉素B期间出现严重恶心和呕吐，最终选择伏立康唑进行治疗。静脉输注伏立康唑注射液两周后，患者改为口服伏立康唑片5个月。在伏立康唑初始静脉治疗后，患者出现呼吸困难加重，需要气管插管进行呼吸机支持，并静脉给予甲泼尼龙5天。所有病变均吸收，出院后第三个月随访时未发现明显不适。目前，该患者已随访3年多无复发。该病例旨在提高医生对非地方性地区和艾滋病毒阴性患者中这种罕见疾病的认识。
