급성 골수성 백혈병 환자에서 치명적 Scedosporium prolificans 진균혈증 1예
A Case of Fatal Scedosporium prolificans Fungemia in a Patient with Acute Myeloid Leukemia
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Scedosporium prolificans는 자연환경에 널리 분포하고 있는 토양잡균으로 최근 보고가 늘고 있는 진균이다. S. prolificans는 특히 심한 호중구 감소로 면역력이 저하된 환자에서 심각한 파종성 감염을 일으킨다. 저자들은 45세 여자 환자가 급성 골수성 백혈병의 재발로 치료 받던 중 Scedosporium 진균혈증으로 사망한 예를 보고하고자 한다. 환자는 구제 항암화학요법과 복합항생제요법을 시행을 받았으며 심한 백혈구 감소증과 재발성 열이 있었다. S. prolificans는 2회 연속적으로 호기성 배양병에서 2일째 검출되었다. 환자는 균이 동정되기 전 경험적 amphotericin B 치료를 시작하였으나 다음날 사망하였다.
Abstract
Scedosporium prolificans is a saprophytic fungus widespread in the environment. It has become an emerging pathogen in recent years causing disseminated infections, especially in profoundly neutropenic immunocompromised patients. We report a case of fatal Scedosporium fungemia in a 45 year old female with acute myeloid leukemia in relapse. She received salvage chemotherapy and antibiotic treatment, and was neutropenic with relapsing fever. S. prolificans was isolated repeatedly from the aerobic bottles on the second day of two successive blood cultures. Amphotercin B was started; however, the patient expired the next day.
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