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Title: Fungal infections in marrow transplant recipients under antifungal prophylaxis with fluconazole
Authors: Oliveira, José Salvador Rodrigues de [UNIFESP]
Kerbauy, Fábio Rodrigues [UNIFESP]
Colombo, Arnaldo Lopes [UNIFESP]
Bahia, Daniella Marcia Maranhão [UNIFESP]
Pinheiro, Gevina Silva [UNIFESP]
Silva, Maria Regina Regis [UNIFESP]
Ribeiro, M.s.s.
Raineri, G.
Kerbauy, José [UNIFESP]
Universidade Federal de São Paulo (UNIFESP)
Casa de Saúde Santa Marcelina Serviço de Hematologia
Keywords: Bone marrow transplantation
Fungal infections
Fluconazole prophylaxis
Issue Date: 1-Jul-2002
Publisher: Associação Brasileira de Divulgação Científica
Citation: Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 35, n. 7, p. 789-798, 2002.
Abstract: Fungal infection is one of the most important causes of morbidity and mortality in bone marrow transplant (BMT) recipients. The growing incidence of these infections is related to several factors including prolonged granulocytopenia, use of broad-spectrum antibiotics, conditioning regimens, and use of immunosuppression to avoid graft-versus-host disease (GvHD). In the present series, we report five cases of invasive mold infections documented among 64 BMT recipients undergoing fluconazole antifungal prophylaxis: 1) A strain of Scedosporium prolificans was isolated from a skin lesion that developed on day +72 after BMT in a chronic myeloid leukemic patient. 2) Invasive pulmonary aspergillosis (Aspergillus fumigatus) was diagnosed on day +29 in a patient with a long period of hospitalization before being transplanted for severe aplastic anemia. 3) A tumoral lung lesion due to Rhizopus arrhizus (zygomycosis) was observed in a transplanted patient who presented severe chronic GvHD. 4) A tumoral lesion due to Aspergillus spp involving the 7th, 8th and 9th right ribs and local soft tissue was diagnosed in a BMT patient on day +110. 5) A patient with a history of Ph1-positive acute lymphocytic leukemia exhibited a cerebral lesion on day +477 after receiving a BMT during an episode of severe chronic GvHD. At that time, blood and spinal fluid cultures yielded Fusarium sp. Opportunistic infections due to fungi other than Candida spp are becoming a major problem among BMT patients receiving systemic antifungal prophylaxis with fluconazole.
ISSN: 0100-879X
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