Concomitant amphotericin B therapy, granulocyte transfusions, and GM-CSF administration for disseminated infection with Fusarium in a granulocytopenic patient

Clin Infect Dis. 1993 Apr;16(4):528-30. doi: 10.1093/clind/16.4.528.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Agranulocytosis / complications*
  • Agranulocytosis / etiology
  • Agranulocytosis / therapy
  • Amphotericin B / therapeutic use*
  • Blood Component Transfusion*
  • Combined Modality Therapy
  • Fusarium* / isolation & purification
  • Granulocyte-Macrophage Colony-Stimulating Factor / therapeutic use*
  • Granulocytes
  • Humans
  • Leukemia, Myeloid, Acute / complications
  • Male
  • Middle Aged
  • Mycoses / etiology
  • Mycoses / microbiology
  • Mycoses / therapy*
  • Skin / pathology

Substances

  • Amphotericin B
  • Granulocyte-Macrophage Colony-Stimulating Factor