| RRC ID |
47076
|
| 著者 |
Shindo M, Sato K, Jimbo J, Hosoki T, Ikuta K, Sano A, Nishimura K, Torimoto Y, Kohgo Y.
|
| タイトル |
[Breakthrough pulmonary mucormycosis during voriconazole treatment after reduced-intensity cord blood transplantation for a patient with acute myeloid leukemia].
|
| ジャーナル |
Rinsho Ketsueki
|
| Abstract |
A 59-year-old man was admitted to our hospital with a diagnosis of acute myeloid leukemia in September 2004. He developed invasive pulmonary aspergillosis (IPA) and candidiasis, which were improved by administration of micafungin and amphotericin B (AMPH-B). He received reduced-intensity unrelated cord-blood transplantation without induction chemotherapy. He developed grade IV graft-versus-host disease (GVHD) and the administration of steroids against GVHD was prolonged. Voriconazole (VRCZ) was used for a long period to prevent recurrence of the IPA. Afterwards, infiltrates in the bilateral upper lung fields were detected on a chest CT scan, and a diagnosis of pulmonary mucormycosis was made following detection of Mucor circinelloides from the patient's sputum culture. He then began receiving AMPH-B but died of massive hemoptysis. Mucormycosis usually occurs in immunocompromised hosts such as neutropenic patients with hematologic diseases and is a fatal fungal infection characterized by a rapid and progressive clinical course. Some overseas investigators have recently reported that VRCZ prophylaxis may result in breakthrough mucormycosis in hematopoietic stem cell transplant recipients. These findings suggest that it is very important to pay attention to mucormycosis in hematopoietic stem cell transplant recipients in this country.
|
| 巻・号 |
48(5)
|
| ページ |
412-7
|
| 公開日 |
2007-5-1
|
| PMID |
17571588
|
| MeSH |
Amphotericin B / therapeutic use
Antifungal Agents / adverse effects*
Antifungal Agents / therapeutic use
Aspergillosis / prevention & control
Cord Blood Stem Cell Transplantation*
Echinocandins
Fatal Outcome
Graft vs Host Disease / drug therapy
Humans
Immunocompromised Host*
Immunosuppressive Agents / adverse effects*
Leukemia, Myeloid, Acute / therapy*
Lipopeptides
Lipoproteins / therapeutic use
Lung Diseases, Fungal / etiology*
Lung Diseases, Fungal / prevention & control
Male
Micafungin
Middle Aged
Mucormycosis / etiology*
Peptides, Cyclic / therapeutic use
Pyrimidines / adverse effects*
Transplantation Conditioning*
Triazoles / adverse effects*
Voriconazole
|
| リソース情報 |
| 病原微生物 |
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