异体移植术后茄病镰刀菌血流感染一例

Fusarium Solani Funfemia Infection in a Patient after Xenogenic Transplantation

目的 提高临床对免疫系统低下患者血流感染少见深部真菌的认识,加强实验室对其培养、鉴定的能力,了解其临床表现和治疗方案.方法 报道实验室发现的一例确诊重症再生障碍性贫血患者异体移植术后血流感染茄病镰刀菌的临床表现、实验室检查和病原体的培养鉴定,并进行相关文献的复习.结果 患者分泌物普通细菌培养为镰刀菌和大肠埃希菌,血培养为镰刀菌,分别对这两株镰刀菌进行乳酸酚棉兰染色、分子生物学基因测序,鉴定结果为茄病镰刀菌.结论 茄病镰刀菌对造血干细胞移植术后的感染在国内尚比较少见,但国外报道感染率明显高于国内,且治疗困难,应引起临床和实验室的共同重视.而分子生物学的鉴定方法对其快速准确诊断提供了依据.

Objective To improve clinical understanding of rare deep fungal infection as a complication in patients with a weekened immune systerm, enhance the capability of cultivation and identification, discuss the diagnosis and appropriate therapy. Methods Symptoms, physical examination,laboratory tests, pathogen cultivation and identification of Fusarium solani infection in a patient with severe aplastic anemia after xenogenic transplantation were retrospectivelv analjyzed,and rehated literatures reviewed. Results The patient＇s secretions culture result was certified to be Fusarium and Escherichia coli by ordinary bacterial culturing,Fusarium by blood culturing. Dyed the two Fusarium by lactophenol-cotton blue solution, and sequenced the gene by molecular biology respectively. The result of gene sequencing of two Fusariurn solani sequenced was the same. Conclusion Fusarium solani infection was rare after hematopoietic stem cell transplantation. However, the infection rates abroad was significantly higher than that in domestic, and it was difficult to treat which should be brought to the forefront. Except morphology,molecular organism is also a good method to identificy Fusarium solani.