Kurnatowska Ilona, Pazurek Marek, Nowicki Michał
Department of Nephrology, Hypertension and Kidney Transplantation, Medical University of Lódz, Lódz, Poland.
Ann Transplant. 2007;12(3):39-42.
Renal transplant patients are at high risk for bacterial, viral and fungal infections. The infections occur characteristically within well-defined risk periods after transplantation, but their clinical presentation is frequently atypical. Candida albicans is the normal part of body flora but in immunocompromized patient this pathogen may lead to severe opportunistic diseases.
A case of esophageal candidosis due to Candida albicans in a 56-year-old female patient, who was one year after kidney transplantation, is reported. The clinical manifestations of gastrointestinal candidosis were atypical and the patient was initially suspected of having a malignancy. She developed several complications of esophageal candidiasis such as ulceration, bleeding and esophageal obstruction secondary to stricture and mycetoma formation. Eventually the patient achieved clinical and mycological recovery after the prolonged treatment with systemic antimycotics.
The fungal infections may occur in different periods after transplantation, have atypical manifestations and require systemic long-term therapy.
肾移植患者面临细菌、病毒和真菌感染的高风险。感染通常在移植后的明确风险期内发生,但其临床表现往往不典型。白色念珠菌是人体正常菌群的一部分,但在免疫功能低下的患者中,这种病原体可能导致严重的机会性疾病。
报告了一例56岁女性肾移植术后一年因白色念珠菌引起食管念珠菌病的病例。胃肠道念珠菌病的临床表现不典型,患者最初被怀疑患有恶性肿瘤。她出现了食管念珠菌病的多种并发症,如溃疡、出血以及继发于狭窄和真菌瘤形成的食管梗阻。最终,患者在接受全身抗真菌药物的长期治疗后实现了临床和真菌学康复。
真菌感染可能发生在移植后的不同时期,表现不典型,需要进行全身性长期治疗。