급성 전골수구성 백혈병(M3) 환자에서 플루코나졸로 치료한 간 칸디다증

일반적으로 대부분의 임상의들은 혈액학적 악성질환 환자들에게 항암화학요법 이후 간 칸디다증이 진단되며 amphotericin B를 우선 정주 한다. 그러나 본 증례에서처럼 혈액진 균배양검사 결과상에서 배양이 되지 않을 경우 amphotericin B의 정주 후에도 임상소견 및 거사실 소견의 호전이 없다면 fluconazole의 정주로 치료 전략을 바꾸는 것이 바람직 하다고 생각한다. The frequency of invasive fungal infections has increased during the period of chemotherapy. Fungal infections are an increasing cause of morbidity and mortality in patients with hematological malignancies. The most common organism are Candida albicans. This report describes our experience in a 28-year-old woman who developed symptoms of hepatic candidiasis which were confirmed with liver biopsy after remission induction chemotherapy for acute myeloid leukemia. In our case, the patient did not improve clinically despite administration of 610 mg amphotericin B. Severe leukocytosis, increasing alkaline phosphatase and clinical deterioration developed rapidly, and then we switched to flconazole, taking into consideration successful fluconazole treatment of patients with chronic disseminated candidiasis and acute hepatic candidiasis. She remains in clinically and radiological improving at the time of this report.