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肾移植术后毛霉菌病的成功治疗。

Successful treatment of mucormycosis after kidney transplantation.

作者信息

Miladipour Amirhossein, Ghanei Esmat, Nasrollahi Alireza, Moghaddasi Habibollah

机构信息

Division of Nephrology, Department of Internal Medicine, Shohada-e-Tajrish Hospital, Shahid Beheshti University (MC), Tehran, Iran.

出版信息

Iran J Kidney Dis. 2008 Jul;2(3):163-6.

Abstract

Fungal infections are rare but represent serious complications following organ transplantation. We present a case of mucormycosis primarily affecting the paranasal sinuses in a 51-year-old man with a kidney allograft. The patient presented with headache, left facial and orbital pain, nasal discharge, and elevation of serum creatinine 18 months after kidney transplantation. Laboratory tests revealed cyclosporine nephrotoxicity, cytomegalovirus infection, and prediabetes. Imaging findings were compatible with left maxillary, ethmoidal, and sphenoidal sinusitis. Diagnosis was made based on pathologic findings and detection of typical fungal hyphea in the infected tissues. The patient was successfully treated by discontinuation of cyclosporine and mycophenolate mofetil, initiation of systemic amphotericin B, and aggressive surgical debridement.

摘要

真菌感染较为罕见,但却是器官移植后的严重并发症。我们报告一例毛霉病病例,主要累及一名51岁肾移植受者的鼻窦。该患者在肾移植18个月后出现头痛、左侧面部及眼眶疼痛、流涕以及血清肌酐升高。实验室检查显示环孢素肾毒性、巨细胞病毒感染和糖尿病前期。影像学检查结果符合左侧上颌窦、筛窦和蝶窦炎。诊断基于病理检查结果以及在感染组织中检测到典型的真菌菌丝。通过停用环孢素和霉酚酸酯、开始使用全身性两性霉素B以及积极的手术清创,该患者得到了成功治疗。

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