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糖尿病肾移植受者肺毛霉菌病的综合药物与手术治疗

Combined medical surgical therapy for pulmonary mucormycosis in a diabetic renal allograft recipient.

作者信息

Lee E, Vershvovsky Y, Miller F, Waltzer W, Suh H, Nord E P

机构信息

Division of Nephrology, Department of Medicine, School of Medicine, State University of New York at Stony Brook, Stony Brook, NY 11794, USA.

出版信息

Am J Kidney Dis. 2001 Dec;38(6):E37. doi: 10.1053/ajkd.2001.29293.

Abstract

Mucormycosis is a rare opportunistic infection that complicates chronic debilitating diseases and immunosuppressed solid-organ transplant recipients. We present a case of life-threatening pulmonary mucormycosis in a diabetic renal allograft recipient who survived with reasonable renal function. Early recognition of this entity and prompt use of bronchoalveolar lavage (BAL) are critical to the outcome. Antifungal therapy combined with early surgical excision of infected, necrotic tissue appears to be the preferred course of action. Judicious withholding of immunosuppressants until fungemia cleared did not jeopardize allograft function.

摘要

毛霉菌病是一种罕见的机会性感染,常使慢性衰弱性疾病和免疫抑制的实体器官移植受者病情复杂化。我们报告一例糖尿病肾移植受者发生危及生命的肺毛霉菌病,该患者存活且肾功能良好。早期识别该疾病并及时进行支气管肺泡灌洗(BAL)对预后至关重要。抗真菌治疗联合早期手术切除感染坏死组织似乎是首选的治疗方案。在真菌血症清除之前明智地停用免疫抑制剂并未危及移植肾功能。

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