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2.
BMC Infect Dis ; 20(1): 527, 2020 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-32698804

RESUMO

BACKGROUND: Conidiobolus spp. (mainly C. coronatus) are the causal agents of rhino-facial conidiobolomycosis, a limited soft tissue infection, which is essentially observed in immunocompetent individuals from tropical areas. Rare cases of invasive conidiobolomycosis due to C. coronatus or other species (C.incongruus, C.lamprauges) have been reported in immunocompromised patients. We report here the first case of invasive pulmonary fungal infection due to Conidiobolus pachyzygosporus in a Swiss patient with onco-haematologic malignancy. CASE PRESENTATION: A 71 year-old female was admitted in a Swiss hospital for induction chemotherapy of acute myeloid leukemia. A chest CT performed during the neutropenic phase identified three well-circumscribed lung lesions consistent with invasive fungal infection, along with a positive 1,3-beta-d-glucan assay in serum. A transbronchial biopsy of the lung lesions revealed large occasionally septate hyphae. A Conidiobolus spp. was detected by direct 18S rDNA in the tissue biopsy and subsequently identified at species level as C. pachyzygosporus by 28S rDNA sequencing. The infection was cured after isavuconazole therapy, recovery of the immune system and surgical resection of lung lesions. CONCLUSIONS: This is the first description of C. pachyzygosporus as human pathogen and second case report of invasive conidiobolomycosis from a European country.


Assuntos
Conidiobolus/genética , Leucemia Mieloide Aguda/complicações , Pneumopatias Fúngicas/complicações , Pneumopatias Fúngicas/diagnóstico , Zigomicose/complicações , Zigomicose/diagnóstico , Idoso , Antifúngicos/uso terapêutico , Biópsia , Conidiobolus/isolamento & purificação , DNA Fúngico/genética , DNA Ribossômico/genética , Feminino , Humanos , Hifas/isolamento & purificação , Hospedeiro Imunocomprometido , Pneumopatias Fúngicas/tratamento farmacológico , Pneumopatias Fúngicas/patologia , Nitrilos/uso terapêutico , Piridinas/uso terapêutico , Suíça , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Triazóis/uso terapêutico , Zigomicose/tratamento farmacológico , Zigomicose/patologia
3.
Rev Chilena Infectol ; 37(1): 77-81, 2020 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-32730404

RESUMO

The episodes of febrile neutropenia are severe cases that require an exhaustive etiological study and a quick start of antimicrobial agents. Within the possible microorganisms, fungal origins are also found, and depending on its tissue invasion, they can reach a high mortality rate. A case of a pediatric patient who suffered from acute myeloid leukemia is reported, and after his induction chemotherapy, the patient showed an episode of febrile neutropenia, which matches a rhinosinusal infection caused by Exserohilum rostratum, a filamentous fungi that is uncommonly associated with pathological cases. An antifungal therapy and an early surgical treatment were started, which lead to a positive response, without complications to the patient. After the monitoring and receiving secondary prophylaxis during the episodes of neutropenia, the patient hasn't presented new injuries nor rhinosinusal damage.


Assuntos
Antifúngicos , Ascomicetos , Leucemia Mieloide Aguda , Micoses , Sinusite , Antifúngicos/uso terapêutico , Ascomicetos/isolamento & purificação , Criança , Humanos , Leucemia Mieloide Aguda/complicações , Micoses/complicações , Micoses/tratamento farmacológico , Neutropenia/etiologia , Sinusite/complicações , Sinusite/tratamento farmacológico , Sinusite/microbiologia , Resultado do Tratamento
5.
Rinsho Shinkeigaku ; 60(7): 504-507, 2020 Jul 31.
Artigo em Japonês | MEDLINE | ID: mdl-32536666

RESUMO

This is the rare case report that bilateral vagus nerve paralysis was emerged as the initial symptom of acute myelogenous leukemia (AML). An 83-year-old man admitted to our hospital because of dysphagia. His dysphagia progressed two months prior to admission. Although physical examination revealed no abnormality, videoendoscopy and videofluorography examination clearly revealed bilateral vagus nerve palsy. Brain MRI showed hypointense signals at the bilateral clivus on T1 weighted images, suggesting tumor infiltration to bilateral petroclivus. He was diagnosed as AML by blood samples and bone marrow biopsy. After initiation of the treatment including radiation therapy, dysphagia shows mild improvement. Although bilateral cranial nerve palsy due to malignant tumor involving at the clivus is very uncommon, we should pay attention to the symptom.


Assuntos
Doenças dos Nervos Cranianos/etiologia , Transtornos de Deglutição/etiologia , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/diagnóstico , Nervo Vago , Idoso de 80 Anos ou mais , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Diagnóstico Diferencial , Imagem de Difusão por Ressonância Magnética , Humanos , Masculino
6.
BMC Infect Dis ; 20(1): 404, 2020 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-32517658

RESUMO

BACKGROUND: Carbapenem is frequently used when gram negative bacilli (GNB) bacteremia is detected especially in neutropenic patients. Consequently, appropriate treatment could be delayed in GNB bacteremia cases involving organisms which are not susceptible to carbapenem (carba-NS), resulting in a poor clinical outcomes. Here, we explored risk factors for carba-NS GNB bacteremia and its clinical outcomes in patients with acute myelogenous leukemia (AML) that underwent chemotherapy. METHODS: We reviewed all GNB bacteremia cases that occurred during induction or consolidation chemotherapy, over a 15-year period, in a tertiary-care hospital. RESULTS: Among 489 GNB bacteremia cases from 324 patients, 45 (9.2%) were carba-NS and 444 (90.8%) were carbapenem susceptible GNB. Independent risk factors for carba-NS GNB bacteremia were: carbapenem use at bacteremia onset (adjusted odds ratio [aOR]: 91.2; 95% confidence interval [95%CI]: 29.3-284.1; P < 0.001); isolation of carbapenem-resistant Acinetobacter baumannii (aOR: 19.4, 95%CI: 3.4-112.5; P = 0.001) in the prior year; and days from chemotherapy to GNB bacteremia (aOR: 1.1 per day, 95%CI: 1.1-1.2; P < 0.001). Carba-NS bacteremia was independently associated with in-hospital mortality (aOR: 6.6, 95%CI: 3.0-14.8; P < 0.001). CONSLUSION: Carba-NS organisms should be considered for antibiotic selection in AML patients having these risk factors.


Assuntos
Farmacorresistência Bacteriana , Infecções por Bactérias Gram-Negativas/diagnóstico , Leucemia Mieloide Aguda/patologia , Acinetobacter baumannii/efeitos dos fármacos , Acinetobacter baumannii/isolamento & purificação , Adulto , Idoso , Antibacterianos/farmacologia , Antineoplásicos/uso terapêutico , Carbapenêmicos/farmacologia , Estudos de Casos e Controles , Feminino , Infecções por Bactérias Gram-Negativas/complicações , Infecções por Bactérias Gram-Negativas/microbiologia , Infecções por Bactérias Gram-Negativas/mortalidade , Mortalidade Hospitalar , Humanos , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Razão de Chances , Estudos Retrospectivos , Fatores de Risco , Centros de Atenção Terciária , Resultado do Tratamento
8.
Jpn J Clin Oncol ; 50(8): 889-896, 2020 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-32458984

RESUMO

OBJECTIVE: The relationship between body mass index and overall survival has been controversial in patients who suffered from hematological malignancies and underwent hematopoietic stem cell transplantation. METHODS: We collected the data of 686 acute leukemia patients who received only one allogeneic hematopoietic stem cell transplantation in our center from 2008 to 2017. Patients were divided into four groups (underweight, normal weight, overweight and obesity) according to their body mass index pre-hematopoietic stem cell transplantation. RESULTS: 56.4% of patients had normal body mass indices, 17.3% were underweight, 20.4% were overweight and 5.8% were with obesity. Concerning long-term follow-up, the probability of overall survival was significantly lower in overweight (P = 0.010) and patients with obesity (P = 0.065) as compared with normal weight patients, and no statistically significant difference between underweight and normal weight individuals (P = 0.810). The results demonstrated that higher body mass index was associated with poorer overall survival (hazard ratio: 1.79; 95% confidence interval: 1.33-2.40, P < 0.001) and shorter leukemia-free survival (hazard ratio: 1.78; 95% confidence interval: 1.35-2.34, P < 0.001). Additionally, patients exhibiting a higher body mass index were more likely to face the problem of relapse (30.6 vs 20.9%, P < 0.001). Furthermore, non-relapse mortality of patients with obesity was statistically higher than normal weight patients (22.5 vs 9.6%, P = 0.027). Besides, individuals with a higher abdominal girth had shorter survival (hazard ratio: 1.73; 95% confidence interval: 1.29-2.31, P < 0.001) and higher relapse rate (hazard ratio: 1.78; 95% confidence interval: 1.29-2.45, P = 0.001) as compared with those with a lower abdominal girth. CONCLUSION: Our results indicate that obesity at pre-hematopoietic stem cell transplantation stage, whether characterized by higher body mass index or abdominal girth, is correlated with poorer outcome.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/terapia , Obesidade/complicações , Adolescente , Adulto , Criança , Intervalo Livre de Doença , Feminino , Transplante de Células-Tronco Hematopoéticas/mortalidade , Humanos , Estimativa de Kaplan-Meier , Leucemia Mieloide Aguda/mortalidade , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Recidiva Local de Neoplasia/patologia , Sobrepeso/complicações , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Magreza/complicações , Transplante Homólogo , Resultado do Tratamento , Adulto Jovem
9.
Int J Infect Dis ; 96: 570-572, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32470607

RESUMO

We report the use of extracorporeal membrane oxygenation (ECMO) in a 28-year-old woman who had an influenza infection complicated with severe acute respiratory distress syndrome (ARDS) during treatment for acute myeloid leukemia. Despite ventilator management with positive end-expiratory pressure, nitrogen oxide inhalation, and prone positioning, there was severe hypoxemia. ECMO led to improvement in gas exchange and lung mechanics. This case shows that ECMO can be lifesaving in the treatment of immunocompromised patients who have hypoxemia that is refractory to conventional treatment.


Assuntos
Oxigenação por Membrana Extracorpórea/métodos , Influenza Humana/complicações , Leucemia Mieloide Aguda/complicações , Síndrome do Desconforto Respiratório do Adulto/terapia , Adulto , Feminino , Humanos , Hospedeiro Imunocomprometido , Influenza Humana/imunologia , Leucemia Mieloide Aguda/imunologia , Síndrome do Desconforto Respiratório do Adulto/etiologia , Síndrome do Desconforto Respiratório do Adulto/imunologia
10.
Int J Hematol ; 112(1): 46-56, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32451786

RESUMO

We analyzed clinical cutoffs for defining computed tomography (CT) methods for sarcopenia and examined the prognostic value of CT for allogeneic hematopoietic stem cell transplantation (allo-HCST) outcomes of patients with myeloid malignancy. One hundred twenty-five adult patients with acute myeloid leukemia and myelodysplastic syndrome who underwent first allo-HSCT between 2000 and 2017 were included. Sarcopenia was assessed using CT-based skeletal muscle index (SMI) and mean muscle attenuation at L3. A statistical difference in SMI was confirmed between sarcopenia (n = 52) and nonsarcopenia (n = 73) patients. There were no significant correlations of muscularity with age, performance status, or other characteristics of HSCT. After 2 years, overall survival (OS) was 43.5% and 70.1%, disease-free survival was 52.9% and 68.6%, nonrelapse mortality (NRM) was 20.8% and 8.4%, incidence of acute GVHD (≥ grade 2) was 38.8% and 39.1%, that of chronic GVHD was 53.2% and 37.3%, and median duration of hospitalization was 88 days and 74 days (P = 0.026), respectively, in the sarcopenia and nonsarcopenia groups. Multivariate analysis showed that presence of sarcopenia is a novel adverse factor for high NRM and poor OS. Pretransplant CT-defined sarcopenia is correlated with decreased OS, increased NRM, and prolonged hospitalization.


Assuntos
Transplante de Células-Tronco Hematopoéticas/mortalidade , Leucemia Mieloide Aguda/mortalidade , Leucemia Mieloide Aguda/terapia , Síndromes Mielodisplásicas/mortalidade , Síndromes Mielodisplásicas/terapia , Sarcopenia/diagnóstico por imagem , Sarcopenia/etiologia , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Feminino , Humanos , Leucemia Mieloide Aguda/complicações , Masculino , Pessoa de Meia-Idade , Síndromes Mielodisplásicas/complicações , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Transplante Homólogo , Adulto Jovem
11.
Ann Biol Clin (Paris) ; 78(2): 187-190, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32319947

RESUMO

Acute myeloid leukemia (AML) with inv(16) is primarily associated with the eosinophilic LAM4 form belonging to the favorable prognosis group of AML. We report the case of an 18-year-old man with acute myeloid leukemia with unusual inversion of chromosome 16. Cytological, phenotypic and cytogenetic investigations showed a divergence from those in the literature. Indeed, the myelogram shows a medullary infiltration by elements blocked at the stage of myeloblates/promyelocytes, containing Auer rods grouped sometimes in fagots in blasts, promyelocytes and neutrophils. In view of this pathognomonic aspect, the diagnosis of AML type M3 is mentioned but quickly questioned by the results of immunophenotyping in favor of a maturing AML (M2). The karyotype and the FISH later objectify a recurrent anomaly "cytologically unexpected" inversion 16 (p13, q22) associated with trisomy 22.


Assuntos
Inversão Cromossômica , Cromossomos Humanos Par 16 , Leucemia Mieloide Aguda/diagnóstico , Adolescente , Cromossomos Humanos Par 22/genética , Citodiagnóstico , Análise Citogenética , Humanos , Imunofenotipagem , Cariotipagem , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/genética , Masculino , Trissomia/diagnóstico , Trissomia/genética
12.
Am J Transplant ; 20(7): 1879-1881, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32243697

RESUMO

Coronavirus Disease 2019 (COVID-19) has become a pandemic since March 2020. We describe here 2 cases of COVID-19 infection in a posttransplant setting. First one is a 59-year-old renal transplant recipient; the second is a 51-year-old allogeneic bone marrow transplant recipient. Both patients were on immunosuppressant therapy and had stable graft function before COVID-19 infection. After the diagnosis of COVID-19, immunosuppressive agents were discontinued and methylprednisolone with prophylactic antibiotics were initiated, however, the lung injury progressed. The T cells were extremely low in both patients after infection. Both patients died despite the maximal mechanical ventilatory support. Therefore, the prognosis of COVID-19 pneumonia following transplantation is not optimistic and remains guarded. Lower T cell count may be a surrogate for poor outcome.


Assuntos
Transplante de Medula Óssea , Infecções por Coronavirus/complicações , Falência Renal Crônica/complicações , Transplante de Rim , Leucemia Mieloide Aguda/complicações , Pneumonia Viral/complicações , Transplantados , Antibacterianos/administração & dosagem , Infecções Bacterianas/complicações , China , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Infecção Hospitalar/complicações , Evolução Fatal , Humanos , Imunossupressores/administração & dosagem , Falência Renal Crônica/cirurgia , Leucemia Mieloide Aguda/terapia , Masculino , Metilprednisolona/administração & dosagem , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Complicações Pós-Operatórias , Prognóstico , Respiração Artificial , Linfócitos T/citologia
13.
Rev. chil. obstet. ginecol. (En línea) ; 85(2): 155-161, abr. 2020. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1115511

RESUMO

OBJETIVO: Remarcar la importancia de hacer un adecuado diagnóstico diferencial de la anemia y trombocitopenia en la gestante, ya que en ocasiones enmascaran cuadros tan graves como la leucemia. Presentar un caso de leucemia mieloide aguda con una preeclampsia sobreañadida y describir el proceso diagnóstico y terapéutico llevado a cabo. CASO CLÍNICO: Secundigesta, 25 años, gestante de 37 semanas, con antecedentes de preeclampsia, derivada desde atención primaria por alteración analítica y malestar general. A su llegada a urgencias el cuadro clínico es compatible con un Síndrome de HELLP. Tras el estudio del mismo se llega a la certeza de que se trata de una preeclampsia asociada a una leucemia mieloide aguda que ha simulado los parámetros analíticos de un Síndrome de HELLP. CONCLUSIONES: Es importante el adecuado estudio etiológico de la anemia y trombocitopenia en la gestación. La leucemia exige al clínico un abordaje precoz y multidisciplinar tanto diagnóstico como terapéutico.


OBJECTIVE: To emphasize on the importance of performing a precise differential diagnosis of anaemia and thrombocytopenia during pregnancy, as they can be due to important diseases as leukemia. A case of acute myeloid leukemia associated with preeclampsia is reported, describing the complexity of the diagnostic and therapeutic process. CLINICAL CASE: 25-year-old woman, gravida 2, para 1 (preeclampsia), at 36 weeks of gestation was referred to the emergency department by her primary care physician due to severe disturbance on the blood tests and general discomfort. Initially, a HELLP syndrome was suspected. However, after going in depth in the case, the final diagnosis was preeclampsia associated to acute myeloid leukemia, simulating blood parameters in HELLP syndrome. CONCLUSIONS: It is essential to study deeply and carry out a complete differential diagnosis process of anaemia and thrombocytopenia during pregnancy. Leukemia requires an early multidisciplinary management both for diagnosis and treatment.


Assuntos
Humanos , Feminino , Adulto , Pré-Eclâmpsia/diagnóstico , Complicações Neoplásicas na Gravidez , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/diagnóstico , Trombocitopenia/etiologia , Síndrome HELLP/diagnóstico , Diagnóstico Diferencial , Anemia/etiologia
16.
Med. infant ; 27(1): 3-9, Marzo de 2020. Tab
Artigo em Espanhol | LILACS, BINACIS, UNISALUD | ID: biblio-1118423

RESUMO

Las infecciones bacterianas son una de las principales causas de morbimortalidad en los niños con cáncer. Nuestro objetivo fue describir y comparar las características clínicas y los microorganismos causantes de bacteriemias con su sensibilidad antimicrobiana en niños con diagnóstico de LLA y LMA. Se realizó un estudio observacional, descriptivo entre julio-2016 y junio-2018. Se incluyeron todos los episodios de bacteriemia (EpB) en pacientes de 0 a 18 años con diagnóstico de LLA y LMA. Se documentaron datos epidemiológicos y demográficos de los pacientes y datos microbiológicos de los aislamientos de hemocultivos positivos. Se utilizó stata13. Se incluyeron 258 EpB en 167 pacientes; el 55% eran varones. La mediana de edad fue 81 meses (RIC 39-130). En 215 EpB (83%) se registró la presencia de algún tipo de catéter; neutropenia en 193 EpB (75%), neutropenia severa en 98/258 EpB (38%). Se pudo determinar el foco clínico en 152 EpB (59%). Ciento diez pacientes tenían LLA y 57 LMA. En LLA predominaron las enterobacterias, en LMA los cocos gram positivos. Se observó asociación entre LMA y estreptococos del grupo Viridans (p<0,01) y entre LLA y P.aeruginosa (p 0,01). Con respecto a la sensibilidad hubo 11% y 17% de bacilos negativos multirresistentes en LLA y LMA respectivamente. Todos los estafilococos coagulasa negativos fueron meticilino resistentes. La mayoría de los pacientes tenía algún tipo de catéter y neutropenia. Se observó un predominio de enterobacterias con bajos niveles de resistencia antibiótica. Estos resultados son importantes para conocer la epidemiología local y establecer tratamientos empíricos adecuados (AU)


Bacterial infections are one of the main causes of morbidity and mortality in children with cancer. Our aim was to describe and compare the clinical features and bacteremia-causing microorganisms together with their antimicrobial sensitivity in acute lymphocytic (ALL) and acute myelocytic leukemia (AML). A descriptive observational study was conducted between July 2016 and June 2018. All episodes of bacteremia (EpB) in patients between 0 and 18 years of age with ALL and AML were included. All epidemiological and demographic data of the patients and microbiological information of the isolates of the positive blood cultures were recorded. For statistical analysis stata13 was used. Overall 258 EpB in 167 patients were included; 55% were boys. Median age was 81 months (IQR 39-130). In 215 EpB (83%) some type of catheter was involved; neutropenia was observed in 193 EpB (75%) and severe neutropenia in 98/258 EpB (38%). A clinical focus could be determined in 152 EpB (59%). Of all patients, 110 had ALL and 57 AML. The predominant micro-organisms were enterobacteria in ALL and gram-positive cocci in AML. An association was observed between AML and the viridans group of streptococci (p<0.01) and between ALL and P. aeruginosa (p 0.01). Regarding sensitivity, there were 11% and 17% of multiresistant negative bacilli in ALL and AML, respectively. All coagulase-negative staphylococci weer methicillin resistant. The majority of patients had some type of catheter and neutropenia. Predominance of enterobacteria with low levels of resistance to antibiotics was observed. These results are important to understand the local epidemiology and establish adequate empirical therapies (AU)


Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Leucemia Mieloide Aguda/complicações , Testes de Sensibilidade Microbiana , Bacteriemia/microbiologia , Bacteriemia/epidemiologia , Farmacorresistência Bacteriana , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Hemocultura , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Positivas/isolamento & purificação , Argentina/epidemiologia , Estudos Retrospectivos , Estudos de Coortes
19.
Pediatr Hematol Oncol ; 37(5): 431-437, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32166993

RESUMO

D-2-hydroxyglutaric aciduria (D-2-HGA) is a rare metabolic disorder characterized by developmental delay, hypotonia, and bi-allelic mutations in D-2-hydroxyglutarate dehydrogenase (D2HGDH) or a single gain-of-function mutation in isocitrate dehydrogenase 2 (IDH2). Metaphyseal chondromatosis with D-2-hydroxyglutaric aciduria (MC-HGA) is a type of D-2-HGA that has been previously reported in ten patients (OMIM 614875), three of whom had somatic mosaicism for R132 variants in isocitrate dehydrogenase 1 (IDH1). We describe a 3-year-old boy with MC-HGA who subsequently developed acute myeloid leukemia (AML) and was found to have an IDH1 R132C mutation in a leukemic bone marrow sample. Further testing revealed presence of somatic mosaicism for IDH1 R132C variant, suggesting an association of IDH1 in inducing myeloid leukemogenesis.


Assuntos
Encefalopatias Metabólicas Congênitas/genética , Condromatose/genética , Isocitrato Desidrogenase/genética , Leucemia Mieloide Aguda/genética , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Encefalopatias Metabólicas Congênitas/complicações , Pré-Escolar , Condromatose/complicações , Condromatose/tratamento farmacológico , Transplante de Células-Tronco Hematopoéticas , Humanos , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/tratamento farmacológico , Masculino , Mutação , Resultado do Tratamento
20.
J Infect Chemother ; 26(5): 506-509, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32146107

RESUMO

Schizophyllum commune, a basidiomycete fungus, is a quite rare cause of invasive sinusitis for which no standard treatment has yet been established. We report herein a 59-year-old woman who developed S. commune rhinosinusitis after remission induction chemotherapy for her acute myeloid leukemia. No causative microorganisms were identified in the sinus lavage fluid culture, whereas nucleotide sequencing of the internal transcribed spacer region using endoscopic sinus biopsy specimen could confirm the pathogen as S. commune. Liposomal amphotericin B and voriconazole (VRCZ) treatment ameliorated both her clinical symptoms and laboratory findings. The patient was successfully treated with allogeneic stem cell transplantation, under continuous VRCZ administration, without aggravation of S. commune sinusitis. Molecular diagnosis and prompt intervention with suitable antifungal drugs may be crucial to manage this rare infectious complication.


Assuntos
Transplante de Células-Tronco Hematopoéticas/métodos , Infecções Fúngicas Invasivas/complicações , Leucemia Mieloide Aguda/terapia , Rinite/microbiologia , Schizophyllum/patogenicidade , Sinusite/microbiologia , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Quimioterapia Combinada , Feminino , Humanos , Infecções Fúngicas Invasivas/diagnóstico , Infecções Fúngicas Invasivas/tratamento farmacológico , Infecções Fúngicas Invasivas/microbiologia , Leucemia Mieloide Aguda/complicações , Pessoa de Meia-Idade , Técnicas de Diagnóstico Molecular , Rinite/complicações , Rinite/diagnóstico , Rinite/tratamento farmacológico , Schizophyllum/genética , Schizophyllum/isolamento & purificação , Sinusite/complicações , Sinusite/diagnóstico , Sinusite/tratamento farmacológico , Transplante Homólogo , Resultado do Tratamento , Voriconazol/uso terapêutico
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