Lima Emerson Q, Silva Ricardo G, Fernandes Ida M M, Abbud-Filho Mário, Burdmann Emmanuel A
Division of Nephrology, Hospital de Base, São Jose do Rio Preto Medical School, 15090-000 São José do Rio Preto, SP, Brazil.
Am J Trop Med Hyg. 2007 Aug;77(2):400-2.
A 48-year-old renal transplant recipient who developed tetanus 6 years after transplantation is described. His immunosuppressive protocol was mofetil mycophenolate, sirolimus, and prednisone. The patient presented symptoms of severe tetanus with autonomic dysfunction, requiring ICU care and mechanical ventilation. His clinical course was marked by development of tetanus-induced acute kidney injury and sepsis. He was discharged after 37 days of hospitalization with recovered renal function. Tetanus is a preventable disease associated with a high fatality rate. Its treatment is difficult and requires specialized and intensive care. This case highlights the crucial importance of following adequate immunization guidelines in transplant recipients.
本文描述了一名48岁的肾移植受者，他在移植6年后发生了破伤风。他的免疫抑制方案包括霉酚酸酯、西罗莫司和泼尼松。该患者出现了伴有自主神经功能障碍的严重破伤风症状，需要重症监护病房护理和机械通气。他的临床病程以破伤风诱发的急性肾损伤和脓毒症为特征。住院37天后，他肾功能恢复，随后出院。破伤风是一种可预防但死亡率很高的疾病。其治疗困难，需要专业的重症护理。该病例凸显了移植受者遵循适当免疫指南的至关重要性。
