Ho T A, Rommelaere M, Coche E, Yombi J-C, Kanaan N
Division of Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain Medical School, Brussels, Belgium.
Transpl Infect Dis. 2010 Apr;12(2):138-42. doi: 10.1111/j.1399-3062.2009.00473.x. Epub 2009 Nov 19.
The most common presentations of nontuberculous mycobacterial infections in kidney transplant recipients (KTR) are cutaneous and disseminated diseases. Pleuropulmonary infection not associated with disseminated disease is rare. Its diagnosis can be difficult, requiring a combination of clinical, radiological, and bacteriological criteria. We report on a Mycobacterium avium complex pulmonary infection in a KTR with underlying chronic obstructive pulmonary disease. Chest computed tomography showed an excavated lesion of the right upper lobe, similar to a typical lesion of pulmonary tuberculosis. Evolution was favorable with multiple-drug therapy including rifampicin, ethambutol, and clarithromycin, along with a slight reduction in immunosuppression. We review the literature and discuss the epidemiology, diagnosis, management, and follow-up of this uncommon post-transplant complication.
肾移植受者（KTR）非结核分枝杆菌感染最常见的表现是皮肤和播散性疾病。不伴有播散性疾病的胸膜肺部感染很少见。其诊断可能很困难，需要结合临床、放射学和细菌学标准。我们报告了一例患有潜在慢性阻塞性肺疾病的KTR发生鸟分枝杆菌复合群肺部感染的病例。胸部计算机断层扫描显示右上叶有空洞性病变，类似于典型的肺结核病变。采用包括利福平、乙胺丁醇和克拉霉素在内的多药治疗，同时略微降低免疫抑制，病情好转。我们回顾了文献，并讨论了这种不常见的移植后并发症的流行病学、诊断、管理和随访情况。
