Dornbusch H J, Urban C E, Pinter H, Ginter G, Fotter R, Becker H, Miorini T, Berghold C
Division of Hematology/Oncology, University Children's Hospital Graz, Austria.
Pediatr Hematol Oncol. 1995 Nov-Dec;12(6):577-86. doi: 10.3109/08880019509030772.
Five children with malignancies developed invasive pulmonary aspergillosis during chemotherapy-induced neutropenia. All patients were treated with liposomal amphotericin B and human recombinant granulocyte colony-stimulating factor. Two patients did not recover from bone marrow aplasia and died from organ-infiltrating fungal invasion. Two patients who recovered from bone marrow aplasia survived after surgery of the pulmonary lesions. The fifth patient had a complete resolution of invasive pulmonary aspergillosis after neutrophil recovery without surgical intervention. We conclude that not only the antifungal treatment but also the recovery of granulocytes are important in localizing invasive forms of Aspergillus infections in patients with profound immunosuppression.
五名患有恶性肿瘤的儿童在化疗引起的中性粒细胞减少期间发生了侵袭性肺曲霉病。所有患者均接受了脂质体两性霉素B和重组人粒细胞集落刺激因子治疗。两名患者未从骨髓再生障碍中恢复，死于器官浸润性真菌感染。两名从骨髓再生障碍中恢复的患者在肺部病变手术后存活。第五名患者在中性粒细胞恢复后侵袭性肺曲霉病完全消退，无需手术干预。我们得出结论，对于免疫功能严重低下的患者，不仅抗真菌治疗，而且粒细胞的恢复对于定位侵袭性曲霉菌感染都很重要。
