Fouassier M, Joly D, Cambon M, Peigue-Lafeuille H, Condat P
Service de réanimation, Centre Jean-Perrin, Clermont-Ferrand, France.
Rev Med Interne. 1998 Jun;19(6):431-3. doi: 10.1016/s0248-8663(98)80868-0.
Geotrichum capitatum sepsis are rare, occurring exclusively in immunocompromised patients.
We report the case of a patient with acute leukemia, presenting with chemotherapy-induced neutropenia and hospitalized in an intensive care unit for a severe sepsis. In spite of an antibiotic and antifungal treatment, the patient died of cardiorespiratory failure. Later on, blood cultures proved to be positive for Geotrichum capitatum.
If fungal infections are common in neutropenic patients, Geotrichum capitatum sepsis remain exceptional. The portal of entry is digestive or respiratory, and the invasion is favored by immunodepression and suppression of the normal microbial flora. Induced lesions can be multiorganic. The treatment is not well established, and the association of either amphotericine B and 5-fluorocytosine or amphotericine B and itraconazole would lead to better results. Nevertheless, the prognosis is still unfavorable, with a mortality rate of approximately 75%.
头状地霉败血症很罕见,仅发生于免疫功能低下的患者。
我们报告了一例急性白血病患者的病例,该患者因化疗导致中性粒细胞减少,并因严重败血症入住重症监护病房。尽管进行了抗生素和抗真菌治疗,患者仍死于心肺功能衰竭。后来,血培养结果显示头状地霉呈阳性。
如果真菌感染在中性粒细胞减少患者中很常见,那么头状地霉败血症仍然是罕见的。感染途径为消化道或呼吸道,免疫抑制和正常微生物菌群的抑制有利于感染的发生。引发的病变可能累及多个器官。治疗方法尚未明确,两性霉素B与5-氟胞嘧啶联合使用或两性霉素B与伊曲康唑联合使用可能会取得更好的效果。然而,预后仍然不佳,死亡率约为75%。