急性髓系白血病儿童播散性茄病镰刀菌败血症1例及文献复习

目的 探讨急性髓系白血病儿童感染茄病镰刀菌败血症的临床特点及诊疗经过.方法 总结2019年11月四川省自贡市第一人民医院儿童重症医学科收治的1例急性髓系白血病儿童播散性镰刀菌败血症的临床诊疗过程.以"播散性镰刀菌感染"为中文关键词,检索中国知网、万方中文数据库建库至今的相关文献;以"disseminated Fusar...

A case of disseminated Fusarium solani septicemia in a child with acute myeloid leukemia and literature review

Objective To investigate the clinical characteristics and diagnosis and treatment of Fusarium solani septicemia in a child with acute myeloid leukemia.Methods The clinical diagnosis and treatment process of a case of disseminated Fusarium septicemia were reviewed.The patient was a child with acute myeloid leukemia admitted to pediatric ICU in the First People's Hospital of Zigong City,Sichuan Province in November 2019.Relevant reports were retrieved from CNKI and Wanfang databases,PubMed and Google Scholar databases using search words"disseminated Fusarium infection"from January 2000 to January 2020.Results This case was a 13-year-old girl with rash and fever as the first onset symptoms.She had typical skin lesions of Fusarium infection.Her diagnosis was confirmed as disseminated Fusarium infection by skin exfoliation biopsy and blood culture.The pathogen was identified as Fusarium solani based on morphology.After treatment with ambisome(amphotericin B)combined with voriconazole,the child recovered.A total of 38 qualified reports were retrieved.A total of 133 patients with disseminated Fusarium bloodstream infection were reviewed,including this case.The age range was 6 months to 75 years old,including 61 males and 72 females.The main clinical manifestation was persistent fever in 119 patients,and specific skin lesions in 119 patients.The underlying diseases were mainly hematological malignancies.Neutropenia was reported in 113 patients.Overall,51 patients were cured,and 82 died.The overall mortality rate was 61.7%.The mortality rate was 69.6%after amphotericin B treatment.Conclusions Early diagnosis,correcting immunosuppression,and timely and adequate antifungal regimen are key to treatment success of disseminated Fusarium infection.Voriconazole in combination with ambisome is recommended for treatment of Fusarium septicemia.