急性淋巴细胞白血病(ALL)复发患儿化疗后合并侵袭性真菌感染一例

摘要

Fungal infections are commonly seen in patients with hematological disorders,especially hematological malignancies.Hematological malignancies complicated with pulmonary fungal infections are mainly characterized by fever,cough,and pulmonary imaging signs.However,these characteristics,including X-ray and CT image in most pulmonary fungal infections,are not specific.In this case,the patient with acute lymphocytic leukemia developed agranulocytosis and fever after intensive chemotherapy,which could not be controlled by strong antibacterial therapy.The child was empirically diagnosed with pulmonary fungal infection,and regular antifungal therapy was applied.Vfend Tablets showed greater advantages in this treatment.The child received both antifungal therapy and low-dose chemotherapy maintenance therapy.We could see that in patients with acute leukemia complicated with invasive fungal infection,combination of low-dose chemotherapy and anti fungal therapy may facilitate control of the acute leukemia,avoid recurrence,and cure the fungal infection.%真菌感染在血液系统疾病尤其是血液系统恶性疾病中十分常见.血液系统恶性疾病伴肺部真菌感染多表现为发热、咳嗽及肺部影像学改变.但是,肺部的X线及CT等影像学改变多无特异性.本例病例中,急性淋巴细胞白血病患儿在强化疗后出现粒细胞缺乏伴发热,经强有力的抗生素治疗无效.患儿给予经验性抗真菌治疗,最后予威凡片剂治疗后好转.患儿在抗真菌治疗的同时行小剂量化疗,最终患儿白血病治愈,肺部侵袭性真菌感染控制.