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[目的]提高对急性白血病(AL)并发播散性热带念珠菌血症临床特征的认识。[方法]回顾性分析3例AL并发播散性热带念珠菌血症临床表现、诊治过程和转归。[结果]在3例患者中,中性粒细胞(ANC)缺乏时出现持续发热、鹅口疮;B超均发现肝内类圆形或椭圆形多发低回声,血培养均示热带念珠菌生长。3例患者采用两性霉素B(AmpB)联合5氟胞嘧啶治疗后体温正常。[结论]AL并发播散性热带念珠菌血症的诊断需结合病史、临床表现、实验室检查及影像学检查综合判断;选用两性霉素B联合5氟胞嘧啶治疗有较好的临床疗效。
[Objective] To improve the understanding of clinical features of acute leukemia (AL) complicated by disseminated tropical Candida. [Methods] The clinical manifestations, diagnosis, treatment and prognosis of 3 cases of AL complicated with disseminated tropical Candida albicans were retrospectively analyzed. [Result] In 3 patients, persistent fever and thrush occurred in the absence of neutrophils (ANC). All of them showed round or oval hypoechoic lesions in the liver and blood culture showed growth of Candida tropicalis. Three patients with amphotericin B (AmpB) combined with 5 flucytosine treatment of normal body temperature. [Conclusion] The diagnosis of AL complicated with disseminated tropical Candida albicans should be combined with the history, clinical manifestations, laboratory tests and imaging studies to determine comprehensive; amphotericin B combined with 5 flucytosine treatment has good clinical efficacy.