Hung C C, Chang S C, Chen Y C, Tien H F, Hsieh W C
Department of Internal Medicine, National Taiwan University Hospital, Taipei R.O.C.
J Formos Med Assoc. 1995 Mar;94(3):127-31.
Trichosporon beigelii fungemia with localized visceral involvement or dissemination is a life-threatening infection in patients with granulocytopenia. We report three cases of T. beigelii fungemia in patients with acute leukemia seen at the National Taiwan University Hospital. Two patients were in the granulocytopenic state after cytoreductive chemotherapy, while one was in complete remission. Fever persisted or recurred despite conventional antibiotic treatment when fungemia developed. Cutaneous trichosporonosis was noted in one patient, which was misdiagnosed as candidiasis. An indwelling catheter constituted the likely portal of entry in two patients. Therapeutic response to amphotericin B is generally not achieved in patients without recovery of neutrophil counts and in those with retained catheters.
白吉利丝孢酵母菌血症伴局部内脏受累或播散是粒细胞减少患者的一种危及生命的感染。我们报告了国立台湾大学医院收治的3例急性白血病患者发生白吉利丝孢酵母菌血症的病例。2例患者在减瘤化疗后处于粒细胞减少状态，1例处于完全缓解期。发生菌血症时，尽管进行了常规抗生素治疗，发热仍持续或复发。1例患者出现皮肤丝孢酵母菌病，曾被误诊为念珠菌病。2例患者的感染可能经留置导管进入。中性粒细胞计数未恢复的患者以及仍保留导管的患者，通常对两性霉素B治疗无反应。
