Feltkamp M C, Kersten M J, van der Lelie J, Burggraaf J D, de Hoog G S, Kuijper E J
Department of Medical Microbiology, University of Amsterdam, The Netherlands.
Eur J Clin Microbiol Infect Dis. 1997 Jun;16(6):460-4. doi: 10.1007/BF02471912.
The case is described of a 42-year-old patient with acute myeloid leukemia who received two courses of chemotherapy complicated by prolonged bone marrow depression. He was admitted to hospital with fever, hepatosplenomegaly and bilateral nodular pulmonary infiltrates. After admission diffuse cutaneous skin nodules, and hypodense lesions in the hemispheres and cerebellum developed. Cultures of cerebrospinal fluid, bronchoalveolar lavage fluid, skin biopsy specimens and blood revealed Scedosporium prolificans, indicative of disseminated mycosis. Treatment with amphotericin B and fluconazole was unsuccessful and the patient died within five days after admission. Features that may enhance early recognition of Scedosporium prolificans infection by both clinicians and microbiologists, as well as options in the treatment of infection with this fungal agent are discussed.
本文描述了一名42岁急性髓系白血病患者的病例，该患者接受了两个疗程的化疗，并发长期骨髓抑制。他因发热、肝脾肿大和双侧结节性肺浸润入院。入院后出现弥漫性皮肤结节，以及大脑半球和小脑的低密度病变。脑脊液、支气管肺泡灌洗液、皮肤活检标本和血液培养均显示多育赛多孢菌，提示播散性真菌病。两性霉素B和氟康唑治疗无效，患者在入院后五天内死亡。文中讨论了可能提高临床医生和微生物学家对多育赛多孢菌感染早期识别的特征，以及治疗这种真菌病原体感染的选择。
