Abstract
Invasive fungal infections occur frequently in neutropenic patients although only in recent years has the role of emerging fungi been clearly established. We describe two cases of fungemia caused by Trichosporon beigelii and Rhodotorula glutinis respectively in two neutropenic patients with hematological malignancies who were treated with amphotericin B. The first patient, with refractory multiple myeloma, died following massive pneumonia despite therapy with amphotericin B and granulocyte-colony stimulating factor (G-CSF); the second patient, with relapsed acute lymphatic leukemia and persistent fever without any other clinical evidence, finally recovered. Amphotericin B continues to be considered the "gold standard" in the treatment of invasive mycoses although other approaches need to be tested for refractory infections.
MeSH terms
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Adolescent
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Amphotericin B / administration & dosage
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Amphotericin B / therapeutic use*
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Antifungal Agents / administration & dosage
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Antifungal Agents / therapeutic use*
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Female
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Fungemia / drug therapy*
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Fungemia / etiology
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Granulocyte Colony-Stimulating Factor / therapeutic use
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Humans
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Male
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Middle Aged
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Multiple Myeloma / complications
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Multiple Myeloma / drug therapy*
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Multiple Myeloma / microbiology
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Neoplasm Recurrence, Local
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Neutropenia / drug therapy*
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Neutropenia / microbiology
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Pneumonia, Bacterial / complications
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Pneumonia, Bacterial / drug therapy
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Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications
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Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
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Precursor Cell Lymphoblastic Leukemia-Lymphoma / microbiology
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Pseudomonas Infections / complications
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Pseudomonas Infections / drug therapy
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Rhodotorula*
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Treatment Outcome
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Trichosporon*
Substances
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Antifungal Agents
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Granulocyte Colony-Stimulating Factor
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Amphotericin B