Combined anti-fungal therapy and surgical resection as treatment of pulmonary zygomycosis in allogeneic bone marrow transplantation

被引:21
作者
Leleu, X
Sendid, B
Fruit, J
Sarre, H
Wattel, E
Rose, C
Bauters, F
Facon, T
Jouet, JP
机构
[1] Ctr Hosp Reg & Univ Lille, Hop Huriez, Serv Malad Sang, F-59037 Lille, France
[2] St Vincent Hosp, Serv Hematol, Lille, France
[3] Ctr Hosp Reg & Univ Lille, Hop Huriez, Lab Parasitol Mycol, F-59037 Lille, France
关键词
mucormycosis; Absidia corymbifera; Candida glabrata; bone marrow transplant; AmBisome; granulocyte-monocyte colony-stimulating factor;
D O I
10.1038/sj.bmt.1701898
中图分类号
Q6 [生物物理学];
学科分类号
071011 ;
摘要
Opportunistic fungal infection is a rare but severe complication in allogeneic bone marrow transplant (BMT) recipients. We report a 19-year-old patient who developed pneumonitis after BMT, due to a Mucorales fungus (class Zygomycetes), Absidia corymbifera. Infections due to mucormycosis are likely to become increasingly recognized even though the occurrence after BR;IT has only been described sporadically. We postulate that the patient was contaminated before BMT despite no intensive drug treatment or other iatrogenic features, related to his poor living conditions and developed the infection during aplasia, He immediately received i.v. liposomal amphotericin B (AmBisome) and GM-CSF. Because there was no response, the infected area and necrotic tissue were resected, Despite initial clinical and biological improvement and the absence of Mucor on mycological examination post-surgery, the patient died 3 weeks later from bilateral pulmonary infection and multiorgan failure.
引用
收藏
页码:417 / 420
页数:4
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