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脂质体两性霉素 B 治疗伴有葡萄牙念珠菌感染的重症胰腺炎患者失败。

Failure of liposomal amphotericin B therapy in patients with severe pancreatitis complicated by Candida lusitaniae infection.

机构信息

Department of Pharmacy, Showa University Northern Yokohama Hospital, Chigasaki Chuo 35-1, Tsuzuki-ku, Yokohama City Kanagawa, 224-8503, Japan; Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Hatanodai 1-5-8, Shinagawa-ku, Tokyo, 142-8555, Japan.

Department of Pharmacy, Showa University Northern Yokohama Hospital, Chigasaki Chuo 35-1, Tsuzuki-ku, Yokohama City Kanagawa, 224-8503, Japan.

出版信息

J Infect Chemother. 2023 Feb;29(2):208-211. doi: 10.1016/j.jiac.2022.10.011. Epub 2022 Oct 22.

Abstract

Candida lusitaniae is an uncommon pathogen that accounts for approximately 1% of patients with candidiasis. In this report, we present the case of a 24-year-old woman with severe pancreatitis who was emergently admitted to Northern Yokohama Hospital. We started treating the pancreatitis and infections according to her culture results. However, her symptoms, accompanied by a necrotic pancreas, did not improve. Finally, C. lusitaniae was detected in the blood and catheter samples. We started antifungal treatment according to the culture results, but the patient died. Generally, the mortality rate for acute pancreatitis ranges from 3% for patients with interstitial edematous pancreatitis to 17% for those who develop pancreatic necrosis. Although we chose appropriate antibiotics and antifungal agents based on the culture results, the treatments failed. Early detection, sufficient doses of antimicrobials and frequent monitoring using sample culture are crucial because infection control may be inadequate, especially in tissues with low blood flow, such as necrotic tissues.

摘要

葡萄牙假丝酵母是一种不常见的病原体,约占念珠菌病患者的 1%。本报告介绍了一位 24 岁的重症胰腺炎女性患者的病例,她紧急入住横浜北医院。我们根据她的培养结果开始治疗胰腺炎和感染。然而,她的症状,伴有胰腺坏死,没有改善。最终,在血液和导管样本中检测到葡萄牙假丝酵母。我们根据培养结果开始抗真菌治疗,但患者死亡。一般来说,急性胰腺炎的死亡率范围为间质水肿性胰腺炎患者的 3%至胰腺坏死患者的 17%。尽管我们根据培养结果选择了合适的抗生素和抗真菌药物,但治疗失败了。早期检测、足够剂量的抗菌药物和使用样本培养进行频繁监测至关重要,因为感染控制可能不足,特别是在血流低的组织中,如坏死组织。

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