Yao Yu-Fang, Feng Jia, Liu Jie, Chen Chao-Feng, Yu Bo, Hu Xiao-Ping
Department of Dermatology & Venereology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China.
Department of Hematology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China.
World J Clin Cases. 2021 Aug 6;9(22):6443-6449. doi: 10.12998/wjcc.v9.i22.6443.
In recent years, the rate of immunosuppressed patients has increased rapidly. Invasive fungal infections usually occur in these patients, especially those who have had hematological malignances and received chemotherapy. Fusariosis is a rare pathogenic fungus, it can lead to severely invasive infections. Along with the increased rate of immune compromised patients, the incidence of invasive infections has also increased from the past few years. Early diagnosis and therapy are important to prevent further development to a more aggressive or disseminated infection.
We report a case of a 19-year-old male acute B-lymphocytic leukemia patient with fungal infection in the skin, eyeball, and knee joint during the course of chemotherapy. We performed skin biopsy, microbial cultivation, and molecular biological identification, and the pathogenic fungus was finally confirmed to be . The patient was treated with oral 200 mg voriconazole twice daily intravenous administration of 100 mg liposomal amphotericin B once daily, and surgical debridement. Granulocyte colony-stimulating factor was administered to expedite neutrophil recovery. The disseminated infection eventually resolved, and there was no recurrence at the 3 mo follow-up.
Our case illustrates the early detection and successful intervention of a systemic invasive infection. These are important to prevent progression to a more aggressive infection. Disseminate infection requires the systemic use of antifungal agents and immunotherapy. Localized infection likely benefits from surgical debridement and the use of topical antifungal agents.
近年来，免疫抑制患者的比例迅速增加。侵袭性真菌感染通常发生在这些患者中，尤其是那些患有血液系统恶性肿瘤并接受化疗的患者。镰刀菌病是一种罕见的致病真菌，可导致严重的侵袭性感染。随着免疫功能低下患者比例的增加，侵袭性感染的发生率在过去几年中也有所上升。早期诊断和治疗对于防止病情进一步发展为更具侵袭性或播散性感染至关重要。
我们报告一例19岁男性急性B淋巴细胞白血病患者，在化疗过程中皮肤、眼球和膝关节发生真菌感染。我们进行了皮肤活检、微生物培养和分子生物学鉴定，最终确诊致病真菌为 。患者接受口服伏立康唑200mg，每日两次，静脉注射脂质体两性霉素B 100mg，每日一次，并进行手术清创。给予粒细胞集落刺激因子以加速中性粒细胞恢复。播散性 感染最终得到解决，在3个月的随访中无复发。
我们的病例说明了系统性侵袭性 感染的早期发现和成功干预。这些对于防止病情进展为更具侵袭性的感染很重要。播散性 感染需要全身性使用抗真菌药物和免疫治疗。局部感染可能受益于手术清创和局部抗真菌药物的使用。
