急性淋巴细胞白血病治疗并发症--一名儿科患者的白色念珠菌和曲霉菌感染所带来的诊断和治疗挑战:病例报告和文献综述

IF 3.3 3区 医学 Q2 MICROBIOLOGY
Natalia Zaj, Weronika Kopyt, Emilia Kamizela, Julia Zarychta, Adrian Kowalczyk, Monika Lejman, Joanna Zawitkowska
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引用次数: 0

摘要

真菌感染是一项重大挑战,而且仍然是导致儿童白血病治疗失败的主要原因。尽管采取了抗真菌预防措施,但在接受急性淋巴细胞白血病(ALL)治疗的儿童病例中,真菌感染仍占约20%。本研究旨在强调与侵袭性真菌感染(IFIs)相关的诊断和治疗难题。我们还回顾了侵袭性真菌感染在 ALL 患者中的流行病学、风险因素、治疗和临床表现。本病例报告详细介绍了一名5岁儿童患者在ALL巩固治疗阶段确诊白色念珠菌(C. albicans)和曲霉菌属感染的临床过程。这名男性患者在方案 II 实施第 28 天前未出现任何并发症。随后,患者病情恶化。血液培养发现白僵菌生长。尽管实施了针对性治疗,但男孩的病情并没有好转。由于出现呼吸道症状,他不得不接受胸部计算机断层扫描(CT)检查,结果发现多处结节性致密组织,与白僵菌病因不符。尽管一直在进行抗真菌治疗,但 CT 扫描显示的病灶没有消退。肺部活检最终确定感染源为曲霉菌。战胜真菌感染是一项巨大的挑战;因此,准确诊断和及时启动靶向治疗对于控制白血病患者的感染至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnostic and Therapeutic Challenge Caused by Candida albicans and Aspergillus spp. Infections in a Pediatric Patient as a Complication of Acute Lymphoblastic Leukemia Treatment: A Case Report and Literature Review
Fungal infections constitute a significant challenge and continue to be a predominant cause of treatment failure in pediatric leukemia cases. Despite the implementation of antifungal prophylaxis, these infections contribute to approximately 20% of cases in children undergoing treatment for acute lymphoblastic leukemia (ALL). The aim of this study is to highlight the diagnostic and therapeutic challenges associated with invasive fungal infections (IFIs). We also present a review of the epidemiology, risk factors, treatment, and a clinical presentation of IFI in patients with ALL. This case report details the clinical course of confirmed Candida albicans (C. albicans) and Aspergillus spp. infections during the consolidation phase of ALL treatment in a 5-year-old pediatric patient. This male patient did not experience any complications until Day 28 of protocol II. Then, the patient’s condition deteriorated. Blood culture detected the growth of C. albicans. Despite the implementation of targeted therapy, the boy’s condition did not show improvement. The appearance of respiratory symptoms necessitated a computed tomography (CT) of the chest, which revealed multiple nodular densities atypical for C. albicans etiology. In spite of ongoing antifungal treatment, the lesions depicted in the CT scans showed no regression. A lung biopsy ultimately identified Aspergillus species as the source of the infection. Overcoming fungal infections poses a considerable challenge; therefore, an accurate diagnosis and the prompt initiation of targeted therapy are crucial in managing these infections in patients with leukemia.
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来源期刊
Pathogens
Pathogens Medicine-Immunology and Allergy
CiteScore
6.40
自引率
8.10%
发文量
1285
审稿时长
17.75 days
期刊介绍: Pathogens (ISSN 2076-0817) publishes reviews, regular research papers and short notes on all aspects of pathogens and pathogen-host interactions. There is no restriction on the length of the papers. Our aim is to encourage scientists to publish their experimental and theoretical research in as much detail as possible. Full experimental and/or methodical details must be provided for research articles.
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