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)...

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Bibliographic Details
Published in:	Clinical infectious diseases Vol. 16; no. 4; pp. 528 - 530
Main Authors:	Spielberger, Ricardo T., Falleroni, Marc J., Coene, Amy J., Larson, Richard A.
Format:	Journal Article
Language:	English
Published:	Chicago, IL The University of Chicago Press 01-04-1993 University of Chicago Press
Subjects:	Agranulocytosis - complications Agranulocytosis - etiology Agranulocytosis - therapy Amphotericin B - therapeutic use Biological and medical sciences Blood Blood Component Transfusion Blood transfusion Clinical Infectious Disease Articles Colony stimulating factors Combined Modality Therapy Dosage Fungal infections Fusarium Fusarium - isolation & purification Granulocyte-Macrophage Colony-Stimulating Factor - therapeutic use Granulocytes Humans Immunodeficiencies Immunodeficiencies. Immunoglobulinopathies Immunopathology Infections Lesions Leukemia, Myeloid, Acute - complications Male Medical sciences Middle Aged Mycoses - etiology Mycoses - microbiology Mycoses - therapy Neutrophils Skin - pathology Human Immunopathology Transfusion Toxicity Treatment efficiency Cytokine Granulocyte Malignant hemopathy Fungi Case study Antifungal agent Blood cell Chemotherapy Treatment Pancytopenia Fusarium Combined treatment Fungi Imperfecti Granulocyte macrophage colony stimulating factor Thallophyta
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Summary:	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.
Bibliography:	Reprints or correspondence: Dr. Ricardo T. Spielberger, University of Chicago Medical Center, Box MC2115, 5841 South Maryland Avenue, Chicago, Illinois 60637-1470. ark:/67375/HXZ-Q5WH3798-H istex:F18D55011C165C87570CFB057309252445805556 ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	1058-4838 1537-6591
DOI:	10.1093/clind/16.4.528