Fujishita Keigo, Oka Satoshi, Kamei Katsuhiko, Tani Katsuma, Fujisawa Yuka, Kitamura Wataru, Machida Takuya, Imai Toshi
Department of Hematology and Blood Transfusion, Kochi Health Sciences Center, Kochi 781-8555,
Department of Hematology and Blood Transfusion, Kochi Health Sciences Center, Kochi 781-8555, Japan.
Acta Med Okayama. 2020 Oct;74(5):435-441. doi: 10.18926/AMO/60805.
A 53-year-old man was diagnosed with acute myeloid leukemia, which was refractory to chemotherapies. Systemic papules appeared afterward. The skin biopsies revealed filamentous fungal infection including fusariosis. Despite antifungal therapy, the infection did not resolve, because neutropenia persisted with the leukemia. He underwent hematopoietic stem cell transplantation (HSCT) to overcome the leukemia and restore normal hematopoiesis but died from fusariosis just before engraftment. Fusarium fujikuroi species complex was detected in blood cultures with poor antifungal susceptibility. Because restoring normal hematopoiesis is important in the treatment of fusariosis, HSCT might be considered for patients with persistent pancytopenia.
一名53岁男性被诊断为急性髓系白血病,对化疗耐药。此后出现全身性丘疹。皮肤活检显示丝状真菌感染,包括镰刀菌病。尽管进行了抗真菌治疗,但感染并未缓解,因为白血病导致的中性粒细胞减少持续存在。他接受了造血干细胞移植(HSCT)以战胜白血病并恢复正常造血,但在植入前死于镰刀菌病。在血培养中检测到藤仓镰刀菌复合体,其对抗真菌药物敏感性差。由于恢复正常造血在镰刀菌病治疗中很重要,对于持续性全血细胞减少的患者可考虑进行HSCT。