Fujikawa Yuko, Katsuta Yoshihisa, Shibata Yoshiko, Akai Kenjiro, Kamei Katsuhiko
Department of Internal Medicine, Ishinomaki Municipal Hospital, Ishinomaki, JPN.
Medical Mycology Research Center, Chiba University, Chiba, JPN.
Cureus. 2025 Aug 7;17(8):e89531. doi: 10.7759/cureus.89531. eCollection 2025 Aug.
species are known to cause disseminated infections in immunocompromised hosts, typically in patients with hematological malignancies undergoing chemotherapy and those with a history of antifungal use. This case report described a non-neutropenic 85-year-old male patient with fungemia following polymicrobial bacteremia. He presented with fever and disturbed consciousness and was admitted for sepsis (day 1). Blood cultures tested positive for , , , and Methicillin-resistant (MRSA). Sepsis improved with the administration of piperacillin-tazobactam and vancomycin. Blood culture on day 14 was negative for bacteria but positive for yeast-like organisms, which were identified as by mass spectrometry. After voriconazole administration, the blood culture became negative. However, the echocardiograph suggested infectious endocarditis, and vertebral magnetic resonance imaging (MRI) suggested osteomyelitis and epidural abscess of the lumbar spine. Despite long-term antifungal and antibacterial treatments, the patient's general condition deteriorated, and he died of aspiration pneumonia on day 119. Multiple factors, including age, diabetes mellitus, malnutrition, combined with polymicrobial bacteremia, and antibacterial usage, contributed to fungemia. may have invaded the systemic bloodstreamthrough damaged intestinal mucosal tissues. Trichosporonosis has emerged in non-neutropenic individuals. Further investigations of invasive non- fungal infections in this population are required.
已知某些菌种会在免疫功能低下的宿主中引起播散性感染，通常发生在接受化疗的血液系统恶性肿瘤患者以及有抗真菌药物使用史的患者中。本病例报告描述了一名85岁非中性粒细胞减少的男性患者，在发生多微生物菌血症后出现真菌血症。他表现为发热和意识障碍，因脓毒症入院（第1天）。血培养结果显示 、 、 及耐甲氧西林金黄色葡萄球菌（MRSA）呈阳性。使用哌拉西林 - 他唑巴坦和万古霉素后脓毒症有所改善。第14天的血培养细菌结果为阴性，但酵母样生物体呈阳性，通过质谱鉴定为 。给予伏立康唑后，血培养转为阴性。然而，超声心动图提示感染性心内膜炎，脊椎磁共振成像（MRI）提示腰椎骨髓炎和硬膜外脓肿。尽管进行了长期的抗真菌和抗菌治疗，患者的一般状况仍恶化，于第119天死于吸入性肺炎。多种因素，包括年龄、糖尿病、营养不良，再加上多微生物菌血症和抗菌药物的使用，导致了真菌血症。 可能通过受损的肠道黏膜组织侵入了全身血液循环。非中性粒细胞减少个体中已出现毛孢子菌病。需要对该人群中的侵袭性非真菌性感染进行进一步研究。
