Successful treatment of Aspergillus liver abscesses in a patient with acute monoblastic leukemia using combination antifungal therapy including micafungin as a key drug
Successful treatment of Aspergillus liver abscesses in a patient with acute monoblastic leukemia using combination antifungal therapy including micafungin as a key drug
复制标题
使用包括米卡芬净作为关键药物的联合抗真菌疗法成功治疗急性单核细胞白血病患者的曲霉肝脓肿
DOI：
10.1007/s12185-010-0556-2
复制
发表时间：
2010
影响因子：
2.1
通讯作者：
N. Asou
中科院分区：
文献类型：
--
作者：
R. Yamada;K. Horikawa;S. Ishihara;K. Hoshino;T. Kawaguchi;K. Iyama;H. Mitsuya;N. Asou
虽然抗癌化疗改善了恶性血液病患者的生存率，但它也使这些患者面临因中性粒细胞减少而导致的危及生命的感染风险。在白血病的强化化疗中，很少观察到导致死亡的侵袭性曲菌病。在这种情况下，需要积极的诊断和治疗干预。在此，我们报告一个急性单核细胞白血病患者发生曲霉菌性肝脓肿的病例。化疗期间，患者出现发热性中性粒细胞减少症，同时血清β-d-葡聚糖水平升高。肝活检确诊。虽然伏立康唑或脂质体阿替霉素B（两者均推荐用于侵袭性曲霉病）的抗真菌单药治疗反应较差，但当与米卡芬净（一种棘白菌素）联合使用时，两者均对感染具有非常有利的效果。因此，我们的临床经验表明，血清试验是有用的侵袭性曲霉菌病的快速诊断，特别是在深部组织，联合抗真菌治疗与米卡芬净应考虑当初始单一治疗真菌感染显示效果不足。
While anti-cancer chemotherapy has improved the survival of patients with hematologic malignancies, it has also exposed such patients to the risk of life-threatening infection due to neutropenia. In intensive chemotherapy for leukemia, invasive aspergillosis resulting in death is infrequently observed. In such cases, aggressive diagnostic and therapeutic intervention is required. Herein, we report a case of Aspergillus liver abscesses in a patient with acute monoblastic leukemia. The patient presented with febrile neutropenia and concomitantly with an elevated serum β-d-glucan level during chemotherapy. The abscesses were finally diagnosed by liver biopsy. Although antifungal monotherapy of voriconazole or liposomal amphotericin B, both of which are recommended for invasive aspergillosis, showed a poor response, when combined with micafungin, an echinocandin, both had a highly favorable effect against the infection. Therefore, our clinical experience suggests that the serum test is useful for the rapid diagnosis of invasive aspergillosis, especially in deep tissues, and that combination antifungal therapy with micafungin should be considered when initial monotherapy for fungal infection shows an insufficient effect.
影响因子：
11.8
作者：
Upton, Arlo;Kirby, Katharine A.;Marr, Kieren A.
通讯作者：
Marr, Kieren A.