白血病继发毛霉菌病和曲霉菌病混合感染1例并文献复习

张远; 杨明华

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更新时间：2023-06-16

白血病继发毛霉菌病和曲霉菌病混合感染1例并文献复习
Leukemia followed by mucormycosis and aspergillus mixed infection: A case report and literature review
中南大学学报(医学版) 中南大学学报(医学版) 2023年页码：1-8
作者机构：

中南大学湘雅三医院儿科湖南儿童肿瘤性疾病临床医学研究中心，长沙 410013
作者简介：

张远，Email: 1209525492@qq.com, ORCID: 0000-0002-6268-591X
杨明华，Email: yamahua123@163.com, ORCID: 0000-0003-3746-1209
基金信息：

国家自然科学基金(82270185)
DOI：
中图分类号：
CSTR：
网络出版日期： 2023-06-16 ，

收稿日期： 2023-02-05 ，

张远, 杨明华. 白血病继发毛霉菌病和曲霉菌病混合感染1例并文献复习[J]. 中南大学学报(医学版), XXXX, XX(XX): 1-8.

ZHANG Yuan, YANG MingHua. Leukemia followed by mucormycosis and aspergillus mixed infection: A case report and literature review[J]. Journal of Central South University. Medical Science, XXXX, XX(XX): 1-8.
张远, 杨明华. 白血病继发毛霉菌病和曲霉菌病混合感染1例并文献复习[J]. 中南大学学报(医学版), XXXX, XX(XX): 1-8. DOI：10.11817/j.issn.1672-7347.XXXX.230039优先

ZHANG Yuan, YANG MingHua. Leukemia followed by mucormycosis and aspergillus mixed infection: A case report and literature review[J]. Journal of Central South University. Medical Science, XXXX, XX(XX): 1-8. DOI：10.11817/j.issn.1672-7347.XXXX.230039 优先

摘要

白血病继发毛霉菌和曲霉菌混合感染十分少见，诊断困难，进展速度快，严重时可危及生命。本文报道1例急性髓系白血病(AML)儿童化疗后继发毛霉菌和曲霉菌感染儿童的临床特点及诊疗过程。患儿为12岁男性，诱导化疗中出现发热、咳嗽等表现，血液、脑脊液、肺泡灌洗液宏基因组二代测序(mNGS)均检测出微小根毛霉、黄曲霉，先后应用两性霉素B、泊沙康唑、伏立康唑抗真菌治疗，并行皮肤清创术、纤支镜肺泡灌洗及镜下局部用药，患儿感染控制良好。白血病混合真菌感染临床表现无特异性，病情进展快，易出现播散型，应早诊断早治疗，推荐抗真菌药物联合应用，手术有助于改善病情。

Abstract

Leukemia patients complicated with mucor and aspergillus coinfection is very rare. It is difficult to diagnose

progresses rapidly

and can be life-threatening. We reported that the clinical characteristics

diagnosis and treatment of a child with acute myeloid leukemia (AML) who developed mucor and aspergillus coinfection after chemotherapy. This case was a 12-year-old boy who presented with fever and cough during induction chemotherapy. Metagenomic next-generation sequencing (mNGS) of his blood

cerebrospinal fluid and alveolar lavage fluid were detected

Rhizomucor pusillus

and

Aspergillus flavus

. Amphotericin B

posaconazole and voriconazole were successively used for antifungal therapy

and skin debridement

bronchoalveolar lavage and local perfusion under bronchoscopy were performed. The clinical manifestations of leukemia with mixed fungal infection are non-specific. The disease progresses rapidly and is prone to disseminated. Early diagnosis and treatment should be carried out. Combined antifungal therapy is recommended

and surgery is helpful to improve the condition.

关键词

儿童白血病侵袭性真菌病毛霉菌曲霉菌

Keywords

ChildrenLeukemiaInvasive fungal diseaseMucormycosisAspergillus

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