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毛霉菌病导致急性髓系白血病患者脾梗死、胃瘘和脑脓肿:一例报告

Mucormycosis Causing Splenic Infarction, Gastric Fistula, and Brain Abscess in a Patient With Acute Myeloid Leukemia: A Case Report.

作者信息

S da Silveira Fernando, Foureaux Ribeiro Rafael Brito, Branco Mendes Coutinho Sandra Lucia, Soares de Brito Evelin, Meis Jacques F, Corrêa da Costa Marcela Santos, Ribeiro Julival Fagundes, Vanni Tazio

机构信息

Infectious Diseases Service, Hospital de Base, Federal District, Brasilia, Brazil.

Hematology Service, Hospital de Base, Federal District, Brasilia, Brazil.

出版信息

Case Rep Infect Dis. 2024 Dec 18;2024:4079965. doi: 10.1155/crdi/4079965. eCollection 2024.

Abstract

Invasive mucormycosis is an aggressive fungal infection characterized by rapid progression, primarily impacting immunocompromised individuals. Herein, we report a case of splenic infarction in association with gastrointestinal fistula and brain abscess as a rare presentation of mucormycosis biopsy, proven in a 56-year-old patient diagnosed with acute myeloid leukemia. The patient initially sought medical attention with a 3-week history of fever, night sweats, and malaise. Considering the chest computed tomography findings compatible with fungal disease and neutropenia, he underwent broad-spectrum antifungal therapy. Following the occurrence of splenic infarctions and a gastric fistula, the patient underwent a partial gastrectomy and splenectomy. Despite the interventions, the patient did not have a successful outcome and died on the second postoperative day. This case highlights the importance of timely suspicion, immediate antifungal therapy, and surgical intervention to improve the survival prospects of patients with multifaceted manifestations of mucormycosis.

摘要

侵袭性毛霉菌病是一种侵袭性真菌感染,其特征为进展迅速,主要影响免疫功能低下的个体。在此,我们报告一例脾梗死合并胃肠瘘和脑脓肿的病例,这是毛霉菌病的一种罕见表现,经活检证实,患者为一名56岁诊断为急性髓系白血病的患者。该患者最初因发热、盗汗和全身不适3周前来就医。考虑到胸部计算机断层扫描结果与真菌病和中性粒细胞减少症相符,他接受了广谱抗真菌治疗。在出现脾梗死和胃瘘后,患者接受了部分胃切除术和脾切除术。尽管进行了干预,患者仍未获得成功的治疗结果,于术后第二天死亡。该病例强调了及时怀疑、立即进行抗真菌治疗和手术干预对于改善具有多方面表现的毛霉菌病患者生存前景的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eb7/11669425/179bd1f39e0a/CRIID2024-4079965.001.jpg

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