Zazgornik J, Schmidt P, Thurner J, Kopsa H, Deutsch E
Dtsch Med Wochenschr. 1975 Oct 10;100(41):2082-6. doi: 10.1055/s-0028-1106504.
21 of 41 patients developed clinically manifest or systemic Candida albicans infection 1-36 months after renal transplantation. Asymptomatic candiduria was diagnosed in all patients even before the onset of clinical symptoms. Fungal stomatitis was the most frequent clinical sign, followed by mycotic changes in the respiratory, genito-urinary (vaginitis) and gastro-intestinal tract. In five cases intrahepatic biliary stasis was diagnosed in the course of a Candida albicans septicaemia. In 12 patients with renal transplants it was possible, by treatment with nystatin, clotrimazole, flucytosine, miconazole and amphotericine B to control a generalized or clinically manifest Candida albicans infection. Three died of the septicaemia or meningoencephalitis, six as the result of bacterial superinfections. Inspection of the mouth is an important means of early diagnosing fungal infections. Antimycotic treatment should be started if fungal cultures from urine are repeatedly positive even if the clinical findings are still negative.
41例患者中有21例在肾移植后1至36个月出现临床明显的或全身性白色念珠菌感染。甚至在临床症状出现之前,所有患者均被诊断出无症状念珠菌尿。真菌性口炎是最常见的临床体征,其次是呼吸道、泌尿生殖系统(阴道炎)和胃肠道的霉菌变化。在5例白色念珠菌败血症过程中诊断出肝内胆汁淤积。在12例肾移植患者中,通过使用制霉菌素、克霉唑、氟胞嘧啶、咪康唑和两性霉素B进行治疗,有可能控制全身性或临床明显的白色念珠菌感染。3例死于败血症或脑膜脑炎,6例死于细菌二重感染。口腔检查是早期诊断真菌感染的重要手段。即使临床检查结果仍为阴性,但如果尿液真菌培养多次呈阳性,就应开始抗真菌治疗。