急性淋巴细胞白血病患儿肺型毛霉病1例

Y. Kozel, O. Kutsevalova, V. V. Dmitrieva, O. V. Kozyuk, L. B. Kushtova, A. K. Khaspekyan, K. Aslanyan
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引用次数: 0

摘要

肺毛霉菌病是急性淋巴细胞白血病患者的严重感染并发症,在高剂量细胞抑制剂治疗阶段发展。它的特点是极具侵略性,病程进展迅速,如果不进行特殊治疗,可在短时间内致命。由于毛霉对最常用的抗真菌药物,特别是伏立康唑具有耐药性,因此对毛霉进行可靠的验证是必要的。本文报告一例12岁儿童急性淋巴细胞白血病诊断阶段的肺毛霉菌病。该疾病的最初症状(头痛、不适和虚弱、苍白),一般血细胞计数的变化(白细胞增多,高达20万个细胞/μl,单个血小板)。根据检查结果,主要诊断为急性淋巴细胞白血病L2、IFT T-II、CD1a-。在急性淋巴细胞白血病诊断阶段,x线检查显示基础疾病并发右侧肺炎。为了验证肺组织浸润的病因,支气管肺泡灌洗用于微生物诊断,包括酶免疫测定、显微镜和培养。综合所有结果,诊断为侵袭性毛霉病并立即开始抗真菌治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A clinical case of pulmonary form of mucormycosis in a child with acute lymphoblastic leukemia
Mucormycosis of the lungs is a severe infectious complication in patients with acute lymphoblastic leukemia, which develops at the stage of high-dose cytostatic therapy. It is characterized by an extremely aggressive, rapidly progressive course and, without specific treatment, is fatal in a short time. Reliable verification of mucor is necessary due to its resistance to the most commonly used antifungal drugs, particularly to voriconazole.The article presents a clinical case of pulmonary mucormycosis in a 12‑year-old child at the stage of diagnosis of acute lymphoblastic leukemia. The first symptoms of the disease (headaches, malaise and weakness, pallor), changes in the general blood count (hyperleukocytosis up to 200 thousand cells/μl, single platelets). Based on the results of the examination, the main diagnosis was verified for acute lymphoblastic leukemia L2, IFT T-II, CD1a-. At the stage of diagnosis of acute lymphoblastic leukemia, the underlying disease was complicated by the development of right-sided pneumonia according to X-ray examination. To verify the etiology of infiltration of lung tissue, broncho-alveolar lavage was directed to microbiological diagnostics, which included studies: enzyme immunoassay, microscopic and cultural. On the aggregate of all the results obtained, invasive mucormycosis was diagnosed and antifungal therapy was started immediately.
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