儿童白血病化疗后合并全身性真菌感染诊断及治疗体会  

Diagnosis and treatment of fungal infection for children with leukemia and chemotherapy

作　　者：汤静燕[1] 薛惠良[1] 陈静[1] 陈静[1] 潘慈[1] 顾龙君[1] 叶辉[1] 董如 

机构地区：[1]上海第二医科大学附属新华医院/上海儿童医学中心,200127

出　　处：《中国小儿血液》2005年第6期241-243,共3页China Child Blood

摘　　要：目的积累和交流白血病化疗病人合并深部真菌感染时临床经验。方法总结2年中明确诊断深部霉菌感染病人的诊断过程、方法、临床特征、治疗反应和转归。结果确诊深部真菌感染者共5例,均为白血病患儿,感染前或感染中白血病达完全缓解,特征性表现为发热,抗菌素治疗>5天无效,轻中度压痛的多发性硬性皮下小结(2/5例)和肝脾肾散布性低密度病灶(3/5例),需四周以上二性霉素治疗,有明显但可以处理的毒性反应。结论发热、抗菌素治疗无效、硬性皮下小结和肝脾肾散布性低密度病灶时应考虑深部真菌感染,并给予4周以上二性霉素治疗。Objective Accumulate and exchange the experience of disseminated fungal infection in children with leukemia and chemotherapy. Method Analyze the process of diagnosis , clinic characters, respones to treatment and prognosis of fungal infection. Result All the 5 disseminated fungal were leukemias who were in complete leukemia remission before or during fungal infection period. Clinic characters included antibiotics uncontrollable fever , subcutaneous solid nodules, spreading low density lesions in hepatosplenic and kidney. More than four weeks amphotericin B were needed. The side effects of amphotericin B is apparent but manageable. Conclusion Antibiotics uncontrollable fever, subcutaneous solid nodules, spread low density lesions in hepatosplenic and kidney are strongly indicate disseminated fungal infection. It needs more than 4 weeks amphotericin B therapy.

关 键 词：白血病 化疗 深部真菌感染 二性霉素 深部真菌感染 儿童白血病 感染诊断 治疗反应 全身性 化疗后 抗菌素治疗 低密度病灶 白血病患儿 

分 类 号：R733.7[医药卫生—肿瘤]