Disseminated infection with Fusarium in recipients of bone marrow transplants.
Disseminated infection with Fusarium in recipients of bone marrow transplants.
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骨髓移植受者中镰孢菌的播散性感染。
DOI：
10.1093/clinids/13.6.1077
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发表时间：
1991
期刊：
影响因子：
--
通讯作者：
Ramsay,NK
中科院分区：
文献类型：
--
作者：
Gamis,AS;Gudnason,T;Giebink,GS;Ramsay,NK
本文分析了8例骨髓移植受者中10例播散性镰刀菌感染的临床资料和文献报道的31例病例，以描述这种罕见感染的自然史及其对治疗的反应。镰刀菌感染的特征性体征--播散性皮肤结节、真菌血症和多器官受累--是其早期传播倾向的结果。从文献回顾和我们自己的经验来看，似乎以中性粒细胞计数上升的形式恢复吞噬机制（对镰刀菌的主要免疫防御）是临床解决的必要条件。即使在移植物开始充分发挥功能后，镰刀菌也可能无法完全根除，这一点可以从随后发生血小板减少症的患者的高复发率中得到证明。镰刀菌对体外常规抗真菌药物具有高度耐药性，但其进展可能会通过强化抗真菌治疗而减缓，直到恢复足够的中性粒细胞水平。
Clinical data from 10 episodes of disseminated infection withFusariumamong eight recipients of bone marrow transplants and from 31 cases reported previously in the literature were analyzed in an effort to characterize the natural history of this rare infection and its response to therapy. The characteristic signs of fusarial infection - disseminated skin nodules, fungemia, and multipleorgan involvement-are results of its propensity for early spread. From a review of the literature and our own experience, it appears that recovery of phagocytic mechanisms (the primary immunologic defenses againstFusarium) in the form of rising neutrophil counts is mandatory for clinical resolution. Even after a graft begins to function adequately,Fusariummay not be completely eradicated, as evidenced by the high incidence of recurrence among patients with subsequent neutropenic episodes.Fusariumis highly resistant to conventional antifungal drugs in vitro, but its progression may be slowed by intensive antifungal therapy until the recovery of adequate neutrophil levels.