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Zygomycosis in Two Hematologic Cases

机译:两例血液病中的真菌病

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Zygomycosis are invasive mould infections, rarely diagnosed in hematologic patients. Most of the cases published are in patients with prolonged neutropenia, along with other risk factors such as the use of prior broad-spectrum antibiotics (including new antifungal agents, such as voriconazole), diabetes mellitus (with or without ketoacidosis), malnutrition, iron overload (with or without the use of deferoxamine). These infections have poor prognosis due to the involvement of vital anatomic structures and late diagnosis. Until recent years, the treatment was based on high doses of amphotericin B plus surgical debridement. Here we present two patients with hematologic diseases (one with leukemia, the second with aplastic anemia) with an impaired immune system and the diagnosis of zygomycosis. The survival of one of them was mainly due to early diagnosis and surgical debridement; unfortunately the second was misdiagnosed as an extensive ecchymosis due to thrombocytopenia and died with CNS involvement.
机译:真菌病是侵袭性霉菌感染,血液学患者很少诊断出这种病。公布的大多数病例是患有中性粒细胞减少症的患者,以及其他危险因素,例如使用先前的广谱抗生素(包括伏立康唑等新的抗真菌药),糖尿病(伴或不伴酮症酸中毒),营养不良,铁超负荷(使用或不使用去铁胺)。由于重要的解剖结构的介入和晚期诊断,这些感染的预后较差。直到最近几年,这种治疗都是基于高剂量的两性霉素B加上外科清创术。在这里,我们介绍了两名血液系统疾病患者(一名患有白血病,第二名患有再生障碍性贫血),其免疫系统受损,并诊断为合子菌病。其中一例的生存主要是由于早期诊断和手术清创。不幸的是,第二例因血小板减少症被误诊为广泛的瘀斑,并因中枢神经系统受累而死亡。

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