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題名 | Candida Tropicalis Fungemia in Children with Leukemia and Lymphoma=兒童白血病及淋巴癌患者感染Candida tropicalis黴菌菌血症 |
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作者姓名(中文) | 黃璟隆; 楊兆平; 洪悠紀; | 書刊名 | 中華民國小兒科醫學會雜誌 |
卷期 | 34:4 民82.07-08 |
頁次 | 頁257-263 |
分類號 | 417.515 |
關鍵詞 | 兒童白血病; 淋巴癌患者; 黴菌菌血症; Candida tropicalis; |
語文 | 英文(English) |
中文摘要 | 自1978年1月到1990年12月,本科癌症病患經歷了五例黴菌菌血症,其發生率佔全部菌血症的3.4%。Candida tropicalis是所見的唯一致病黴菌。三例發生於癌症治療的誘導期,另兩例發於復發期。所有病人在發生菌血症前,都曾有為期不等的發燒及嚴重的顆粒球缺乏;他們也都事先用了多種抗生素。臨床上病人並無特殊症狀,所見包括發燒、寒顫、腹脹、咳嗽、氣促、乏尿等,只有一個病人有典型的皮膚病變。僅有一位病人存活。我們的結論是,當懷疑有黴菌菌血症時,採取多種檢體的培養,可促成早期診斷;當癌症病人發燒且缺乏顆粒球時,若廣泛性抗生素使用一週以上,但效果不彰時,便應考慮使用抗黴菌藥物,早期治療或可改善病人的存活率。 |
英文摘要 | Five episodes of fungemias are described; all had occurred in children with leukemia or lymphoma between January 1, 1978 and December 31, 1990. These fungemias comprised 3.4% of the total septicemias encountered during that period. Three episodes occurred during the induction phase and two during relapse. All patients had fever of varying degree and duration. In addition to steroids, all were receiving combination antibiotics before the fungemia had occurred. All patients had severe neutropenia lasting more than one week. Bacteremia preceded fun gemia in four patients. Two episodes were diagnosed antemortem. The same species were isolated from other sites in three cases. Fever, chills and gastrointestinal symptoms were the most common clinical features; other symptoms included cough, dyspnea, oliguria and azotemia. One patient experienced skin lesion, dysphagia, hoarseness and hemiparesis. Only one patient survived. The prognosis from fun gemia in leukemia and lymphoma patients is very poor. Empiric antifungal therapy is indicated in neutropenic patients who have recurrent or persistent fever despite one week of broad spectrum antibiotics. Early diagnosis and treatment will aid in improving the overall poor outcome of this disease. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。