中性粒细胞减少儿童的弥散性镰刀菌属感染2例

来源 :世界核心医学期刊文摘(儿科学分册) | 被引量 : 0次 | 上传用户:liongliong459
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Disseminated fusariosis in children is a rare and serious fungal infection, that occurs especially in neutropenic immunosuppressed patients, treated for malignant hemopathy, or bone marrow transplant recipient. Treatment is difficult and mortality is estimated between 50 and 70%in adult patients. Case report 1. -A ten-year-old boy, treated for an acute lymphoblastic leukemia in second relapse, presented a disseminated fusarium spp infection, that occurred during neutropenia. He died due to fusariosis infection in spite of amphotericin B treatment. Case report 2. -A ten-year-old neutropenic girl, treated for an acute myeld leukemia, presented disseminated fusariosis, uncontrolled by amphotericin B. Recovery was observed after voriconazole introduction and resolution of neutropenia. Ten months later, she presented a leukemia’s relapse, treated by new intensive chemotherapy with secondary prophylaxis by voriconazole, without fusariosis’s recurrence. Conclusion. -Voriconazole, a new triazole agent, seems to be an alternative antifungal agent to amphotericin B for disseminated fusarium infection, either at the acute phase or for secondary prophylaxis. Disseminated fusariosis in children is a rare and serious fungal infection, that occurs especially in neutropenic immunosuppressed patients, treated for malignant hemopathy, or bone marrow transplant recipient. Treatment is difficult and mortality is estimated between 50 and 70% in adult patients. Case report 1 . -A ten-year-old boy, treated for an acute lymphoblastic leukemia in second relapse, presented a disseminated fusarium spp infection, that occurred during neutropenia. He died due to fusariosis infection in spite of amphotericin B treatment. Case report 2. - A ten-year-old neutropenic girl, treated for an acute myeld leukemia, presented disseminated fusariosis, uncontrolled by amphotericin B. Recovery was observed after voriconazole introduction and resolution of neutropenia. Ten months later, she presented a leukemia’s relapse, treated by new intensive chemotherapy with secondary prophylaxis by voriconazole, without fusariosis’s recurrence. Conclusion. -Voriconazole, a new tri azole agent, seems to be an alternative antifungal agent to amphotericin B for disseminated fusarium infection, either at the acute phase or for secondary prophylaxis.
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