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一名急性淋巴细胞白血病患儿的脑部毛霉菌病

Brain mucormycosis in a child with acute lymphoblastic leukemia.

作者信息

Damavandi Shahla Ansari, Adib Shadi, Ashayeri Neda

机构信息

Professor of Pediatrics, Department of Hematology-Oncology, Ali Asghar Children's Hospital, Iran University of Medical Sciences, Tehran, IR.

Resident of Pediatrics, Department of Hematology-Oncology, Ali Asghar Children's Hospital, Iran University of Medical Sciences, Tehran, IR.

出版信息

Radiol Case Rep. 2021 Jul 23;16(9):2808-2811. doi: 10.1016/j.radcr.2021.06.049. eCollection 2021 Sep.

Abstract

This article reports a rare case of Brain Mucormycosis in a 12 year-old girl who presented with relapse Acute Lymphoblastic Leukemia (ALL). On the 12th day of chemotherapy, although there was no CNS symptoms, the second Lumbar Puncture (LP) revealedmthe CNS relapse which developed to Into brain abscess presenting with right side hemiparesis. The brain magnetic resonance imaging (MRI) and the brain biopsy revealed small, multifocal necrosis and acute inflammation with septal fungal hyphae branching, which was proven to be caued by Mucormycosis according to Polymerase Chain Reaction (PCR). The patient responded to treatment with intravenous liposomal Amohotericin B and Caspofungin after two months, suggesting that Brain Mucormycosis in ALL cases can be managed with sequential therapy by antifungals.

摘要

本文报道了一例罕见的脑毛霉菌病病例,患者为一名12岁患有复发性急性淋巴细胞白血病(ALL)的女孩。化疗第12天,尽管没有中枢神经系统症状,但第二次腰椎穿刺显示中枢神经系统复发,发展为脑脓肿,伴有右侧偏瘫。脑部磁共振成像(MRI)和脑活检显示有小的多灶性坏死和急性炎症,伴有分隔的真菌菌丝分支,根据聚合酶链反应(PCR)证实为毛霉菌病所致。两个月后,患者对静脉注射脂质体两性霉素B和卡泊芬净治疗有反应,提示ALL病例中的脑毛霉菌病可通过抗真菌药物序贯治疗。

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