长期中性粒细胞减少患者的播散性地头病:一例罕见病例报告及文献复习

A. Nair, Sreethish Sasi, Samar Hashim, M. Al-Maslamani
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引用次数: 1

摘要

播散性真菌血症由于非念珠菌酵母菌是一种机会性感染出现在血液恶性肿瘤与延长中性粒细胞减少。土曲菌属的侵袭性感染极为罕见,仅占所有非念珠菌的1%左右。此类患者的死亡率很高,在文献中很少报道。在这里,我们描述了一个患有治疗抵抗性霍奇金淋巴瘤的中年男性患者,他在中性粒细胞减少期发生侵袭性头状地霉感染,对伏立康唑和两性霉素b的联合治疗反应不佳,他通过血液培养被诊断出来,尽管接受了多种抗真菌药物治疗,但在入院第10天死亡。在长期中性粒细胞减少合并血液系统恶性肿瘤的患者中,头盖骨是致命的真菌血症的原因。在这组患者中,需要高度的怀疑指数来确定播散性地根病,因为延迟治疗会加重死亡率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Disseminated geotrichosis in a patient with prolonged neutropenia: A rare case report and literature review
Disseminated fungemia due to non-Candida yeasts is emerging as an opportunistic infection in hematological malignancies with prolonged neutropenia. Invasive infections by Geotrichum spp. are extremely rare and constitute only about 1% of all non-Candida yeasts. The mortality in such patients is high and is seldom reported in the literature. Here, we describe the case of a middle-aged male with treatment-resistant Hodgkin's lymphoma who developed invasive Geotrichum capitatum infection during his neutropenic phase, with poor response to combination therapy with voriconazole and amphotericin B. He was diagnosed from blood culture but succumbed to death on day 10 of admission in spite of treatment with multiple lines of antifungals. G. capitatum is responsible for fatal fungemia in patients with prolonged neutropenia complicating hematological malignancies. A high index of suspicion is required in this patient group to identify disseminated geotrichosis as delay in treatment worsens mortality.
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