Инфекции, вызванные редкими плесневыми грибами, в гематологии

Повсеместное распространение плесневых грибов и их смертельная опасность для иммунокомпроментированных больных делает данную проблему до настоящего времени одной из нерешенных в онкогематологии. В статье представлено описание 3 случаев развития редких плесневых грибковых инфекций у детей с онкогематологическими заболеваниями. Первый случай – девочка с острым миелобластным лейкозом и развитием Acremonium spp., данный инфекционный эпизод был купирован при применении антимикотической терапии вориконазолом и восстановлении уровня гранулоцитов. У второго пациента с апластической анемией развился инвазивный микоз, вызванный Fusarium spp.; несмотря на проводимую комбинированную противогрибковую терапию и трансфузии донорских гранулоцитов, данная инфекция привела к смерти пациента. В третьем случае у больного с Mucor spp. диагноз был установлен только на аутопсии.

1. Groll A.H., Lehrnbecher T. New antifungal drugs and the pediatric cancer patient: current status of clinical development. Klin Padiatr 2005;217(3): 158–68.

2. Groll A.H., Walsh T.J. Fungal infections in the pediatric patient. In: Anaissie E., McGinnis M., Pfaller M., eds. Clinical mycology. 1-st ed. N.Y.: Churchill Livingstone, 2003. Рp. 417–42.

3. Marr K.A., Carter R.A., Crippa F. et al. Epidemiology and outcome of mould infections in hematopoietic stem cell transplant recipients. Clin Infect Dis 2002;34:909–17.

4. Pagano L., Caira M., Candoni A. et al. The epidemiology of fungal infections in patients with hematologic malignancies: the SEIFEM-2004 study. Haematologica 2006;91:1068–75.

5. Kontoyiannis D.P., Wessel V.C., Bodey G.P. et al. Zigomycosis in the 1990-s in a tertiary – care cancer center. Clin Infect Dis 2000;30:851–6.

6. Musa M.O., Al Eisa A., Halim M. et al. The spectrum of Fusarium infection in immunocompromized patients with haemotological malignancies and in nonimmunocompromized patients: a single institution experience over 10 years. Br J Haematol 2000;108:544–8.

7. Nenoff P., Kelermann S., Schober R. et al. Rhinocerebral zygomycosis following BMT in chronic myelogenous leukemia. Report of a case and review of the literature. Mycoses 1998;41:365–72.

8. Gonzales C.E., Couriel D.R., Walsh T.J. Disseminated zygomycosis in a neutropenic patient: successful treatment with mphotericin B lipid complex and granulocyte colonystimulating factor. Clin Infect Dis 1997;24:192–6.

9. Singh N., Aguado J.M., Bonatti H. et al. Zygomycosis in solid organ transplant recipients: a prospective, matched case- control study to assess risk for disease and outcome. J Infec Dis 2009;200(6): 1002–11.

10. Fincher R.M., Fisher J.F., Lovell R.D. et al. Infection due to the fungus Acremonium (Cephalosporium). Medicine (Baltimore) 1991;70:398–409.

11. Schell W.A., Perfect J.R. Fatal, disseminated Acremonium strictum infection in a neutropenic host. J Clin Microbiol 1996;34:1333–6.

12. Roilides E., Bibashi E., Acritidou E. et al. Acremonium fungemia in two immunocompromised children. Pediatr Infect Dis J 1995;14:548–50.

13. Raad I., Tarrand J., Hanna H. et al. Epidemiology, molecular mycology and invironmental sources of Fusarium infection in patients with cancer. Infect Control Hosp Epidemial 2002;23:532–7.

14. Boutati E.I., Anaissie E.J. Fusarium, a significant emerging pathogen in patients with hematologic malignancy: ten years’ experience at a cancer center and implications for management. Blood 1997;90:999–1008.

15. Gonzales C.E., Rinaldi M.G., Sugar A.M. Zygomycosis. Infect Dis Clin 2002;16:895–914.

16. Caillot D., Mannone L., Cuisenier B., Couaillier J.F. Role of early diagnosis and aggressive surgery in the management of invasive pulmonary aspergillosis in neutropenic patients. Clin Microbiol Infect 2001;7 Suppl 2:54–61.

17. Liles W.C., Huang J.E., Van Burik J.A. et al. Granulocyte colony-stimulating factor administered in vivo augments neutrophilmediated activity against opportunistic fungal pathogens. J Infect Dis 1997;175:1012–5.

18. Sahin B., Paydas S., Cosar E. et al. Role of granulocyte colony-stimulating factor in the treatment of mucormycosis. Eur J Clin Microbiol Infect Dis 1996;15:866–9.

19. Bodey G.P., Anaissie E., Gutterman J. et al. Role of granulocyte-macrophage colony-stimulating factor as adjuvant therapy for fungal infection in patients with cancer. Clin Infect Dis 1993;17:705–7.

20. Tedder M., Spratt J.A., Anstadt M.P. et al. Pulmonary mucormycosis: results of medical and surgical therapy. Ann Thorac Surg 1994;57:1044–50.

21. Walsh T.J., Hiemennz J.W., Seibel N.L. et al. Amphotericin B lipid complex for invasive fungal infections: analysis of safety and efficacy in 556 cases. Clin Infect Dis 1998;26:1383–96.

22. Alexander B., Perfect J., Daly J. et al. Posaconazole as salvage therapy in patients with invasive fungal infections after solid organ transplant. Transplantation 2008;86:791–6.

23. Peel T., Daffy J., Thursky K. et al. Posaconazole as first line treatment for disseminated zygomycosis. Mycoses 2008;51:542–5.

24. Walsh T.J., Kontoyiannis D.P. What is the role of combination therapy in management of zygomycosis? Clin Infect Dis 2008;47:372–4.