Abstract
We present a case of young male treated for a recurrence of Acute Non Lymphoid Leukemia who presented a colonization by C. krusei during prophylaxis with Fluconazole. The fever episode, which he developed while neutropenic, was resolved with the addition of Amphotericin B after the failure of empiric antibiotic therapy. No isolation was performed in blood cultures. A second cycle of antiblastic chemotherapy was needed because of the resistance shown to the first. Despite the prophylaxis with Fluconazole a stream of C. krusei grew in all the blood cultures collected while febrile. Amphotericin B administered did not control the fungemia. We discuss the resistance of C. krusei to Fluconazole.
MeSH terms
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Adult
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Amphotericin B / therapeutic use
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use
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Candida / drug effects*
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Candidiasis / drug therapy
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Candidiasis / etiology
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Candidiasis / microbiology*
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Candidiasis / prevention & control
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Candidiasis, Oral / drug therapy
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Candidiasis, Oral / etiology
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Candidiasis, Oral / microbiology
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Cytarabine / administration & dosage
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Drug Resistance, Microbial
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Drug Therapy, Combination / therapeutic use
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Fatal Outcome
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Fluconazole / pharmacology*
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Fluconazole / therapeutic use
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Flucytosine / therapeutic use
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Fungemia / drug therapy
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Fungemia / etiology
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Fungemia / microbiology*
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Humans
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Leukemia, Myeloid, Acute / complications
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Leukemia, Myeloid, Acute / drug therapy
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Male
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Mitoxantrone / administration & dosage
Substances
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Cytarabine
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Amphotericin B
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Fluconazole
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Mitoxantrone
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Flucytosine