Fang C T, Chang S C, Tang I L, Hsueh P R, Chang Y L, Hung C C, Chen Y C
Department of Internal Medicine, National Taiwan University Hospital, Taipei, ROC.
J Formos Med Assoc. 1997 Feb;96(2):129-33.
Disseminated Fusarium solani infection, with its distinctive skin lesions, is an emerging cause of mortality in bone marrow transplant recipients worldwide. However, it has never been reported before in Taiwan. We report a 21-year-old man with disseminated fusariosis who developed fever, myalgia and generalized erythematous papules on day 8 after undergoing allogeneic bone marrow transplantation for severe aplastic anemia. Histopathology of the skin lesion revealed mycotic emboli. Cultures of both blood and tissue from skin biopsy grew Fusarium solani. Despite amphotericin B therapy, fever persisted and graft failure developed. A second transplantation, using mobilized peripheral blood stem cells from the same donor, was tried but the patient died of progressive multiple organ failure before any evidence of engraftment.
播散性茄病镰刀菌感染及其独特的皮肤损害，是全球范围内骨髓移植受者死亡的一个新出现的原因。然而，此前台湾地区从未有过相关报道。我们报告一名21岁播散性镰刀菌病男性患者，其在因严重再生障碍性贫血接受异基因骨髓移植后第8天出现发热、肌痛和全身性红斑丘疹。皮肤病变的组织病理学检查显示有真菌栓子。皮肤活检的血液和组织培养均生长出茄病镰刀菌。尽管使用了两性霉素B治疗，患者仍持续发热并出现移植物衰竭。尝试进行第二次移植，使用来自同一供者的动员外周血干细胞，但患者在出现任何植入证据之前死于进行性多器官衰竭。
