급성 골수성 백혈병으로 항암치료 중 발생한 파종 칸디다증과 뒤 이은 돌발 폐 털곰팡이증 1예
A Case of Disseminated Candidiasis and Subsequent Breakthrough Pulmonary Mucormycosis after Consolidation Chemotherapy for Acute Myeloid Leukemia
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Invasive fungal infections (IFIs) are an important cause of morbidity and mortality in patients with acute leukemia who are receiving chemotherapy. Primary prophylaxis with antifungal agents has become the standard of care in this setting; as a result, invasive candidiasis has shown a significant reduction. However, broad use of antifungal prophylaxis has led to an increase in breakthrough candidiasis with reduced susceptibility or resistance to fluconazole. In addition, an increase in breakthrough mucormycosis has been reported in studies of voriconazole prophylaxis. We report on a case of disseminated candidiasis and subsequent breakthrough pulmonary mucormycosis in a patient with acute myeloid leukemia undergoing consolidation chemotherapy. To the best of our knowledge, in Korea,this is the first report of these two independent IFIs occurring in a single patient.
Abstract
Invasive fungal infections (IFIs) are an important cause of morbidity and mortality in patients with acute leukemia who are receiving chemotherapy. Primary prophylaxis with antifungal agents has become the standard of care in this setting; as a result, invasive candidiasis has shown a significant reduction. However, broad use of antifungal prophylaxis has led to an increase in breakthrough candidiasis with reduced susceptibility or resistance to fluconazole. In addition, an increase in breakthrough mucormycosis has been reported in studies of voriconazole prophylaxis. We report on a case of disseminated candidiasis and subsequent breakthrough pulmonary mucormycosis in a patient with acute myeloid leukemia undergoing consolidation chemotherapy. To the best of our knowledge, in Korea,this is the first report of these two independent IFIs occurring in a single patient.
참고문헌 (15)
- Robenshtok E., "Antifungal prophylaxis in cancer patients after chemotherapy or hematopoietic stem-cell transplantation : systematic review and meta-analysis", J Clin Oncol, 25, pp.5471~5489 (2007)
- Bow EJ., "Antifungal prophylaxis for severely neutropenic chemotherapy recipients : a meta analysis of randomizedcontrolled clinical trials", Cancer, 94, pp.3230~3246 (2002)
- Enoch DA., "Invasive fungal infections : a review of epidemiology and management options", J Med Microbiol, 55, pp.809~818 (2006)
- Freifeld AG., "Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america", Clin Infect Dis, 52, pp.e56~e93 (2011)
- Wingard JR., "Increase in Candida krusei infection among patients with bone marrow transplantation and neutropenia treated prophylactically with fluconazole", N Engl J Med, 325, pp.1274~1277 (1991)
- Marty FM., "Breakthrough zygomycosis after voriconazole treatment in recipients of hematopoietic stem-cell transplants", N Engl J Med, 350, pp.950~952 (2004)
- Imhof A., "Breakthrough fungal infections in stem cell transplant recipients receiving voriconazole", Clin Infect Dis, 39, pp.743~746 (2004)
- Trifilio S., "Breakthrough fungal infections after allogeneic hematopoietic stem cell transplantation in patients on prophylactic voriconazole", Bone Marrow Transplant, 40, pp.451~456 (2007)
- Kontoyiannis DP., "Zygomycosis in a tertiary-care cancer center in the era of Aspergillus-active antifungal therapy : a case-control observational study of 27 recent cases", J Infect Dis, 191, pp.1350~1360 (2005)
- Siwek GT., "Invasive zygomycosis in hematopoietic stem cell transplant recipients receiving voriconazole prophylaxis", Clin Infect Dis, 39, pp.584~587 (2004)
- Cornely OA., "Posaconazole vs. fluconazole or itraconazole prophylaxis in patients with neutropenia", N Engl J Med, 356, pp.348~359 (2007)
- Kontoyiannis DP., "Hepatosplenic candidiasis. A manifestation of chronic disseminated candidiasis", Infect Dis Clin North Am, 14, pp.721~739 (2000)
- Leventakos K., "Fungal infections in leukemia patients : how do we prevent and treat them?", Clin Infect Dis, 50, pp.405~415 (2010)
- 이동건, "Evidence-Based Guidelines for Empirical Therapy of Neutropenic Fever in Korea", The Korean Journal of Internal Medicine, 26(2), pp.220~252 (2011), 대한내과학회
- Kontoyiannis DP., "Hepatosplenic candidiasis. A manifestation of chronic disseminated candidiasis", Infect Dis Clin North Am, 14, pp.721~739 (2000)
