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恶性血液病伴发念珠菌性关节炎极为罕见。本文报告一例急性单核细胞白血病患者化疗后骨髓抑制和外周血粒细胞缺乏期间并发膝关节炎。多次关节腔积液培养均为热带念珠菌,确诊为热带念珠菌性关节炎。根据体外细菌药敏试验,先后选用伊曲康唑、两性霉素B静脉滴注治疗4-5周,治疗有效,但停药后4-6周复发。后改用氟康唑静脉滴注治疗8周并用两性霉素B关节腔冲洗获治愈。结论:恶性血液病患者并发念珠菌性关节炎虽极为罕见,但在免疫力低下患者中仍有可能发生,宜选用有效药物进行足量、足疗程抗真菌治疗。
Malignant blood disease associated with candidiasis arthritis is extremely rare. This article reports a case of acute myeloid leukemia in patients with myelosuppression and peripheral arthritis during knee osteomyelitis after chemotherapy. Multiple joint effusion cultures were Candida tropicalis, diagnosed with tropical Candida arthritis. According to the bacterial susceptibility test in vitro, itraconazole, amphotericin B intravenous infusion treatment for 4-5 weeks, effective treatment, but relapse 4-6 weeks after stopping drug. After switching to fluconazole intravenous infusion for 8 weeks and amphotericin B joint rinse was cured. CONCLUSIONS: Candida arthritis is extremely rare in patients with hematologic malignancies. However, it is still possible for patients with immunocompromised patients to take adequate antifungal therapy.