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KMID : 1144320170490020142
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감염과 화학요법
2017 Volume.49 No. 2 p.142 ~ p.145
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A Case of Disseminated Infection with Skin Manifestation due to Non-neoformans and Non-gattii Cryptococcus in a Patient with Refractory Acute Myeloid Leukemia
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Park Sun-Seob
Lee Hye-Won
Park Weon-Seo
Hwang Kyoung-Jin
Choi Sang-Il
Choi Mi-Hong
Lee Si-Won
Ko Eun-Jung
Choi Young-Ju
Eom Hyeon-Seok
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Abstract
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Cryptococcus spp. other than Cryptococcus neoformans or Cryptococcus gattii were previously considered saprophytes and thought to be non-pathogenic to humans. However, opportunistic infections associated with non-neoformans and non-gattii species, such as Cryptococcus laurentii and Cryptococcus albidus, have increased over the past four decades. We experienced a case of cryptococcosis caused by non-neoformans and non-gattii spp. in a 47-year-old female with refractory acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation. The patient underwent salvage chemotherapy with fluconazole prophylaxis and subsequently developed neutropenic fever with multiple erythematous umbilicated papules. A skin biopsy revealed fungal hyphae and repetitive blood cultures showed yeast microorganisms that were identified later as C. laurentii by Vitek-II®. Skin lesions and fever began to improve with conventional amphotericin B therapy. The treatment regimen was continued for 21 days until the disseminated cryptococcosis was completely controlled.
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KEYWORD
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Cryptococcosis, Cryptococcus laurentii, non-neoformans, non-gattii cryptococci
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