Hepatosplenic Fungal Abscesses Successfully Treated by Intraportal and Intrahepatic Arterial Administration of Amphotericin B and Fluconazole in a Child with AML (M2).
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An 8-year-old boy was admitted in February 1990 with a diagnosis of AML (M2). By two courses of BHAC, THP-ADR, VP16 and PSL regimen, complete remission was induced after two months, while marked pyrexia persisted. An ultrasonography (US) and computed tomography (CT) revealed multiple abscesses and suggested mycotic etiology. Splenectomy was done and diagnosed candidiasis. He was also treated by administration of amphotericin B (AMPH) and fluconazole (FCZ) through catheter-inserted portal vein and hepatic artery and 5-fluorocytosine. AMPH was administrated at the total dose of 1, 484 mg from portal vein and 1, 395 mg from hepatic artery. Catheter was inserted in portal vein for 136 days, and to hepatic artery for 87 days. A side effect by AMPH was tolerable. On this therapy, the abnormal low density findings in CT and US disappeared and his condition improved. After discontinuence of AMPH and FCZ from catheter-inserted line, he received bone marrow transplantation (BMT) from HLA-matched family donor. In spite of severe bone marrow suppression, he has been well without recurrence of fungal infection. He has now bee well for one and a half years after BMT.
- 特定非営利活動法人 日本小児血液・がん学会の論文
特定非営利活動法人 日本小児血液・がん学会 | 論文
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