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一名急性髓系白血病免疫受损患者的侵袭性头状腐质霉感染:病例报告

Invasive Saprochaete capitata Infection in an Immunocompromised Patient With Acute Myeloid Leukemia: A Case Report.

作者信息

Karrati Siham, Kharbouch Najmeddine, El Hakkouni Awatif

机构信息

Parasitology-Mycology Department, Mohammed VI University Hospital, Cadi Ayyad University, Marrakech, MAR.

出版信息

Cureus. 2025 Jun 2;17(6):e85236. doi: 10.7759/cureus.85236. eCollection 2025 Jun.

Abstract

() is a rare but emerging opportunistic fungal pathogen, identified as an arthroconidial yeast-like filamentous fungus. It can cause potentially life-threatening invasive fungal infections (IFIs) in immunocompromised patients, particularly those with hematological malignancies and profound neutropenia, and is associated with poor clinical outcomes. Diagnosing invasive infections is challenging, relying primarily on clinical suspicion and isolation of the pathogen from blood, other sterile body fluids, or tissue biopsies. Due to its resistance to both echinocandins and fluconazole, presents significant treatment challenges, with no established optimal therapeutic strategy for invasive infections. Here, we present a case of a 46-year-old man with acute myeloid leukemia who developed an invasive infection with fungemia and pulmonary involvement during post-chemotherapy aplasia. Despite profound immunocompromise, the patient successfully recovered following treatment with combination antifungal therapy, which included liposomal amphotericin B and voriconazole. This case highlights the critical importance of early diagnosis and prompt initiation of appropriate antifungal therapy, particularly in immunocompromised patients, to reduce the exceptionally high mortality and morbidity associated with this severe IFI.

摘要

()是一种罕见但正在出现的机会性真菌病原体,被鉴定为关节孢子酵母样丝状真菌。它可在免疫功能低下的患者中引起潜在危及生命的侵袭性真菌感染(IFI),尤其是那些患有血液系统恶性肿瘤和严重中性粒细胞减少症的患者,并且与不良临床结局相关。诊断侵袭性感染具有挑战性,主要依赖于临床怀疑以及从血液、其他无菌体液或组织活检中分离出病原体。由于其对棘白菌素和氟康唑均耐药,()带来了重大的治疗挑战,对于侵袭性感染尚无既定的最佳治疗策略。在此,我们报告一例46岁急性髓系白血病男性患者,在化疗后再生障碍性贫血期间发生了伴有真菌血症和肺部受累的侵袭性()感染。尽管患者免疫功能严重受损,但在接受包括脂质体两性霉素B和伏立康唑在内的联合抗真菌治疗后成功康复。该病例突出了早期诊断和及时启动适当抗真菌治疗的至关重要性,尤其是在免疫功能低下的患者中,以降低与这种严重IFI相关的极高死亡率和发病率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/370f/12220831/a2b26d0a1a6e/cureus-0017-00000085236-i01.jpg

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