CAJ | 학술논문

恶性血液病伴发念珠茵性关节炎极为罕见.本文报告一例急性单核细胞白血病患者化疗后骨髓抑制和外周血粒细胞缺乏期间并发膝关节炎.多次关节腔积液培养均为热带念珠菌,确诊为热带念珠菌性关节炎.根据体外细菌药敏试验,先后选用伊曲康唑、两性霉素B静脉滴注治疗4-5周,治疗有效,但停药后4-6周复发.后改用氟康唑静脉滴注治疗8周并用两性霉素B关节腔冲洗获治愈.结论:恶性血液病患者并发念珠菌性关节炎虽极为罕见,但在免疫力低下患者中仍有可能发生,宜选用有效药物进行足量、足疗程抗真菌治疗.
악성혈액병반발념주인성관절염겁위한견.본문보고일례급성단핵세포백혈병환자화료후골수억제화외주혈립세포결핍기간병발슬관절염.다차관절강적액배양균위열대념주균,학진위열대념주균성관절염.근거체외세균약민시험,선후선용이곡강서、량성매소B정맥적주치료4-5주,치료유효,단정약후4-6주복발.후개용불강서정맥적주치료8주병용량성매소B관절강충세획치유.결론:악성혈액병환자병발념주균성관절염수겁위한견,단재면역력저하환자중잉유가능발생,의선용유효약물진행족량、족료정항진균치료.
Candida arthritis in patient with hematological malignancy is rare.A case of Candida tropicalis arthritis of knee occurred in a patient with acute monocytic leukemia was reported during the recovery phase of post chemotherapy myelosuppression and agranulocytosis.The patient was diagnosed as Candida tropicalis arthritis of knee according to the Candida tropicalis isolated from the synovial fluid.Itraconazole and amphotericin B were intravenously injected for therapy for 4-5 weeks based on the susceptibility test in vitro,which showed better efficacy.But the arthritis relapsed at 4-6 weeks after the drug withdrawal.Tbe curative effect was found in patient after treatment with fluconazol injection and articular cavity douching with amphotericin B for 8 weeks.In conclusion,although Candida arthritis in patient with hematological malignancy is rare,it still occurred in the patient with hypoimmunity.The treatment emphasis showed be placed on the full dosage and full treatment course of antifungal agent.