Fusarium oxysporum에 의한 혈류감염 1예
A Case of Bloodstream Infection Due to Fusarium oxysporum
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Fusarium species는 면역약화환자에서는 호흡기 감염 및 파종성 감염질환을 일으킬 수 있어 최근 새롭게 부각되는 사상형 진균이다. 국내에서는 현재까지 호흡기 감염 혹은 파종성 피부감염을 일으킨 5예가 보고되었다. 저자들은 최근 면역약화환자에서 Fusarium oxysporum에 의한 진균혈증을 경험하였기에 문헌고찰과 함께 보고하는 바이다. 환자는 재발한 급성골수구성백혈병이 있는 13세의 남자 환자로서 고식적 항암화학요법을 시행한 후 입원 35일 발열과 양측 상, 하지에 통증을 동반한 다발성 피부 결절이 발생하였으며, 정맥천자부위에 발적, 부종 등 정맥염의 증상이 발생하였다. 입원 37, 38, 40 및 42일에 실시한 혈액배양에서 동일한 F. oxysporum이 분리되었다. 환자는 고농도 amphotericin B (1.5 mg/kg) 항진균제 치료를 받았으며, 회복되었다. 본 증례는 사상형 진균의 일종인 Fusarium이 면역약화 환자에서 혈류감염을 유발할 수 있음을 확인시켜 주었다.
Abstract
Fusarium species are representative of the emerging group of filamentous molds, which cause respiratory and disseminated infections in immunocompromised patients. To date, only five cases of respiratory or disseminated skin infections due to Fusarium spp. have been described in Korea. Here we describe a fungemia case of Fusarium oxysporum in a 3-year old boy who was neutropenic following chemotheray for leukemia. Fever, painful macules on both extremities and phlebitis on the site of venous blood sampling developed on the day 35 of admission. All four blood cultures obtained on hospital days 37, 38, 40 and 42 yielded the same F. oxysporum. The infection was cured with a high dose (1.5 mg/kg) of amphotericin B. This case shows that Fusarium is among a few filamentous fungi that cause clinically detectable fungemias in immuncompromised hosts.
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