Deep-seated Mycoses in Hematopoietic Disorders.
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概要
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We examined infections complicated by hematopoietic disorders and found that 141 autopsied cases from 1980 through 1991, infections accounted for nearly 50% of the deaths. Forty-four cases of 70 lethal infections were caused by deep-seated mycoses, including 30 cases of aspergillosis and 8 cases of candidiasis. In the annual profile of causes of death, the incidence of aspergillosis and bacterial infection has remained unchanged, while candidiasis, cytomegalovirus infection and <I>Pneumocystis carinii</I> pneumonia have decreased since 1985. To evaluate the clinical effects of G-CSF, we also reviewed granulocytopenic episodes (≤500/μ<I>l</I>) and/or febril episodes (38°C≤; more than 3 days) in 200 cases of hematopoietic disorders from hospital records. A total of 241 episodes were analyzed, excluding 22 episodes of aplastic anemia because of a prolonged period, and G-CSF was used in 36 episodes. The incidence of apparent infection was 86.2% in the G-CSF (+) group, and 68.3% in the G-CSF (-) group. Moreover, episodes in the G-CSF (+) group were accompanied by more severe infections such as sepsis (27.8%) or pneumonia (22.2%) than those of G-CSF (-), 7.3% and 8.8%, respectively. There was one death from systemic candidiasis in the G-CSF (+) group, and two of candidiasis and four of aspergillosis in the G-CSF (-) group. Despite high incidence and severity of the infections, the overall lethal rate of the G-CSF (+) group was lower than that of G-CSF (-) group, 11.1% and 16.1%, respectively.
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