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肝移植受者侵袭性胃肠道接合菌病:病例报告

Invasive gastrointestinal zygomycosis in a liver transplant recipient: case report.

作者信息

Vera Alonso, Hubscher Stefan G, McMaster Paul, Buckels John A C

机构信息

Liver & Hepatobiliary Unit, Queen Elizabeth Hospital, Edgbaston, Birmingham, England, B15 2TH.

出版信息

Transplantation. 2002 Jan 15;73(1):145-7. doi: 10.1097/00007890-200201150-00027.

Abstract

BACKGROUND

Gastric zygomycosis is a rare but potentially lethal complication in transplant patients. Forty-two cases of gastric mucormycosis have been described in the literature, with a mortality of 98%.

METHODS

We report of a case of gastric mucormycosis in a 45-year-old male undergoing liver transplantation for alcohol-induced cirrhosis. The diagnosis was made 20 days after transplantation in a biopsy of a bleeding gastric ulcer identified during a reoperation for a common bile duct stricture.

RESULTS

After the surgical procedure and therapy with amphotericin B, the patient made a good recovery and is alive and well 2 years after transplantation.

CONCLUSIONS

Gastric mucormycosis should be suspected in those patients in whom gastrointestinal symptoms such a pain or bleeding are present. Because the diagnosis is dependent on histology, the importance of biopsy cannot be underestimated. Once diagnosed, a successful outcome depends on effective treatment with amphotericin.

摘要

背景

胃接合菌病是移植患者中一种罕见但可能致命的并发症。文献中已描述了42例胃毛霉菌病病例,死亡率为98%。

方法

我们报告一例45岁男性酒精性肝硬化患者在接受肝移植时发生胃毛霉菌病的病例。诊断是在因胆总管狭窄再次手术期间,对出血性胃溃疡活检后20天做出的,该溃疡在移植后被发现。

结果

经过手术及两性霉素B治疗后,患者恢复良好,移植后2年仍存活且状况良好。

结论

对于出现腹痛或出血等胃肠道症状的患者,应怀疑胃毛霉菌病。由于诊断依赖于组织学检查,活检的重要性不可低估。一旦确诊,成功的治疗效果取决于两性霉素的有效治疗。

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