Demirag A, Elkhammas E A, Henry M L, Davies E A, Pelletier R P, Bumgardner G L, Dorner B, Ferguson R M
The Ohio State University College of Medicine, Department of Surgery, Columbus 43210, USA.
Clin Transplant. 2000 Feb;14(1):8-10. doi: 10.1034/j.1399-0012.2000.140102.x.
Infectious complications after renal transplantation remain a major cause of morbidity and mortality. Mucormycosis is a rare infection in renal transplant recipients; however, mortality is exceedingly high. Risk factors predisposing to this disease include prolonged neutropenia, diabetes, and patients who are immunosuppressed (Singh N, Gayowski T, Singh J, Yu LV. Invasive gastrointestinal zygomycosis in a liver transplant recipient: case report and review of zygomycosis in solid-organ transplant recipients, Clin Infect Dis 1995: 20: 617). Life-threatening infections can occur, as this fungus has the propensity to invade blood vessel endothelium, resulting in hematological dissemination. We report a case of cavitary Rhizopus lung infection, 2 months after renal transplantation, where the patient was treated successfully with Amphotericin B and surgical resection of the lesions with preservation of his allograft function. In this era of intensified immunosuppression, we may see an increased incidence of mucormycosis in transplant population. Invasive diagnostic work-up is mandatory in case of suspicion; Amphotericin B and, in selected cases, surgical resection are the mainstays of therapy.
肾移植后的感染性并发症仍然是发病和死亡的主要原因。毛霉菌病在肾移植受者中是一种罕见的感染；然而，死亡率极高。易患此病的危险因素包括长期中性粒细胞减少、糖尿病以及免疫抑制患者（辛格N、加约夫斯基T、辛格J、于LV。一名肝移植受者的侵袭性胃肠道接合菌病：病例报告及实体器官移植受者接合菌病综述，《临床感染性疾病》1995年；20：617）。由于这种真菌有侵袭血管内皮的倾向，可导致血液播散，因此会发生危及生命的感染。我们报告一例肾移植术后2个月发生的空洞性根霉菌肺部感染病例，该患者接受两性霉素B治疗并手术切除病灶，同时保留了他的移植肾功能，治疗成功。在这个免疫抑制强化的时代，我们可能会看到移植人群中毛霉菌病的发病率增加。如有怀疑，必须进行侵入性诊断检查；两性霉素B以及在某些情况下手术切除是主要的治疗方法。
