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Abstract：
Infections with Scedosporium and Lomentospora species, in particular Lomentospora (previously Scedosporium) prolificans, are nearly universally fatal and rapidly-progressive in the transplant population. We report a case of a patient with diffuse large B-cell lymphoma undergoing myelosuppressive chemotherapy who developed disseminated L. prolificans infection which afterward persisted in his knee joint. The infection was treated with early empiric triple antifungal therapy tailored to synergy studies, growth factors to quickly resolve neutropenia, and aggressive debridement (where possible) of infection sites, including amputation. He achieved an 11-month remission until undergoing autologous hematopoietic stem cell transplantation with deep myelosuppression, wherein recrudescent L. prolificans infection occurred, causing death. We highlight the importance of early treatment, synergy studies, and especially recovery of neutropenia in treating this devastating condition.
摘要：
Scedosporium和Lomentospora的感染，特别是Lomentospora（以前的Scedosporium）prolificans，在移植人群中几乎普遍致命且进展迅速。我们报告了一例接受骨髓抑制化疗的弥漫性大B细胞淋巴瘤患者，该患者发生了播散性长乳杆菌感染，随后持续存在于他的膝关节中。感染采用针对协同作用研究的早期经验性三联抗真菌疗法进行治疗。生长因子快速解决中性粒细胞减少症，和侵袭性清创（在可能的情况下）感染部位，包括截肢.他获得了11个月的缓解，直到接受深度骨髓抑制的自体造血干细胞移植，其中发生了复发的长株乳杆菌感染，导致死亡。我们强调早期治疗的重要性，协同作用研究，特别是在治疗这种破坏性疾病时，中性粒细胞减少症的恢复。
