·病例报告·骨髓移植患者血流混合感染阿萨希毛孢子菌及棒状大孢酵母1例李继霞闵彦(解放军第九六○医院检验科,济南250031)【摘要】患者,女,40岁,患骨髓增生异常综合征。患者骨髓移植术后,反复发热,血培养显示,血流混合感染2株真菌。18S核糖体RNA(18SrRNA)测序结果显示,其中1株真菌为阿萨希毛孢子菌,另1株真菌为棒状大孢酵母。两株真菌为罕见真菌,均对伏立康唑敏感。因鉴定及药敏时间较长,患者未等调整合理抗真菌药物,因持续中性粒细胞缺乏及真菌血症死亡。该病例是国内首次报道血液病患者血流混合感染阿萨希毛孢子菌和棒状大孢酵母。【关键词】阿萨希毛孢子菌;棒状大孢酵母;血液病患者;罕见真菌;快速诊断【中图分类号】R519.8【文献标志码】A【文章编号】1673-3827(2023)18-0340-04AcaseofmixedbloodstreaminfectionofTrichosporonasahiiandMagnusiomycesclavatusinapatientwithbonemarrowtransplantationLIJixia,MINYan(DepartmentofLaboratoryMedicine,The960thHospitalofPLA,Jinan250031,China)【Abstract】A40-year-oldfemalepatientwithmyelodysplasticsyndromehadrecurrentfeverafterbonemarrowtransplanta-tion.Bloodcultureshowedthatthebloodstreamwasinfectedwith2strainsoffungi.18SribosomalRNA(18SrRNA)se-quencingresultsshowedthatoneofthefungiwasTrichosporonassahiiandtheotherwasMagnusiomycesclavatus.Thetwofungiwererarefungi,bothsensitivetovoriconazole.Duetothelongtimeofidentificationanddrugsensitivity,thepatientdidnotwaitfortheadjustmentofreasonableantifungaldrugs,anddiedduetopersistentneutropeniaandfungemia.ThiscasewasthefirstreportinChineseofbloodstreammixedinfectionofTrichosporonasahiiandMagnusiomycesclavatusinpatientswithhematologicaldiseases.【Keywords】Trichosporonasahii;Magnusiomycesclavatus;haematologicalpatients;rareyeasts;rapiddiagnosis[ChinJMycol,2023,18(4):340-343]近年来,非念珠菌及非隐球菌引起的院内真菌感染逐渐增多[1]。罕见真菌侵袭性感染导致白血病患者死亡率可达40%~80%[2]。罕见真菌感染全球共识强烈推荐对罕见真菌进行培养、药敏,并使用分子诊断技术来确认罕见真菌的种属,从而达到辅助治疗的作用[3]。现报道1位骨髓增生异常综合征患者,其在骨髓移植术后血流混合感染罕见真菌阿萨希毛孢子菌及棒状大孢酵母。作者简介:李继霞,女(汉族),硕士,副主任医师.E-mail...
