Concomitant amphotericin B therapy, granulocyte transfusions, and GM-CSF administration for disseminated infection with Fusarium in a granulocytopenic patient.
The use of granulocyte transfusions during amphotericin B treatment of invasive fungal infections in granulocytopenic patients is controversial because of concern about pulmonary complications from leukostasis. Moreover, the administration of granulocyte-macrophage colony-stimulating factor (GM-CSF) to patients with active infections has been questioned because of reports that this cytokine inhibits neutrophil migration into areas of inflammation. We report a case in which the combined use of amphotericin B, granulocyte transfusions, and GM-CSF was safe and life-saving in a pancytopenic patient with disseminated fusarium infection. Histologic evidence of the migration of neutrophils into an area of active infection was found.
Spielberger
R T
RT
Department of Medicine, University of Chicago, Illinois.
Falleroni
M J
MJ
Coene
A J
AJ
Larson
R A
RA
D000380:Agranulocytosis / Q000150:complications* / Q000209:etiology / Q000628:therapy; D000666:Amphotericin B / Q000627:therapeutic use*; D016913:Blood Component Transfusion; D003131:Combined Modality Therapy; D005670:Fusarium / Q000302:isolation & purification; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use*; D006098:Granulocytes; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000209:etiology / Q000382:microbiology / Q000628:therapy*; D012867:Skin / Q000473:pathology
D000666:Amphotericin B; D016178:Granulocyte-Macrophage Colony-Stimulating Factor