Sav Hafize, Altinbas Rabiye, Bestepe Dursun Zehra
Department of Mycology, Kayseri City Hospital, Kayseri, Turkey.
Department of Mycology, Eskisehir City Hospital, Eskisehir, Turkey.
Curr Med Mycol. 2020 Sep;6(3):61-64. doi: 10.18502/cmm.6.3.3982.
complex as a ubiquitous environmental mold is increasingly reported to cause an invasive fungal infection in immunosuppressive hosts. Herein, we present the case of an immunosuppressive 54 - year-old man who developed complex lung infection and pulmonary adenocarcinoma.
The patient had some complaints of dyspnea and cough during a neutropenic episode. The computed tomography (CT) scan of the patient revealed pleural effusion. After culturing the pleural fluid sample, the fungus was identified by microscopic examination and ITS sequencing. In addition, antifungal susceptibility testing was performed using the M38-A2 microdilution method. The minimum inhibitory concentrations of amphotericin B, voriconazole, posaconazole, and caspofungin were obtained as > 64, 0.06, 0.06, and 0.03 µg/mL, respectively. Voriconazole (administered in two doses of 6 mg/kg and a maximum of 250 mg) was preferred for treatment. The patient received antifungal treatment for 2 months; however, he was lost to follow-up.
complex should be considered a cause of systemic fungal infections in neutropenic patients. Furthermore, the determination of the in vitro antifungal susceptibilities of clinical strains may contribute to the development of therapeutic approaches.
曲霉作为一种普遍存在的环境霉菌,越来越多地被报道可在免疫抑制宿主中引起侵袭性真菌感染。在此,我们报告一例54岁免疫抑制男性患者,其发生了曲霉肺部感染和肺腺癌。
该患者在中性粒细胞减少发作期间出现呼吸困难和咳嗽等症状。患者的计算机断层扫描(CT)显示有胸腔积液。对胸腔积液样本进行培养后,通过显微镜检查和ITS测序鉴定出真菌。此外,使用M38 - A2微量稀释法进行了抗真菌药敏试验。两性霉素B、伏立康唑、泊沙康唑和卡泊芬净的最低抑菌浓度分别为>64、0.06、0.06和0.03µg/mL。治疗首选伏立康唑(分两次给药,剂量为6mg/kg,最大剂量为250mg)。该患者接受了2个月的抗真菌治疗;然而,失访了。
曲霉应被视为中性粒细胞减少患者系统性真菌感染的一个病因。此外,临床菌株体外抗真菌药敏性的测定可能有助于制定治疗方案。