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肾移植受者的皮下结节与感染性并发症

Subcutaneous nodules and infectious complications in renal allograft recipients.

作者信息

Caroti L, Zanazzi M, Rogasi P, Fantoni E, Farsetti S, Rosso G, Bertoni E, Salvadori M

机构信息

Renal Unit, Azienda Ospedaliera Universitaria Careggi, Florence, Italy.

出版信息

Transplant Proc. 2010 May;42(4):1146-7. doi: 10.1016/j.transproceed.2010.03.115.

Abstract

Renal transplant recipients are at increased risk of infectious diseases and subject to cutaneous infections because of the effects of immunosuppressive therapy. Some long-term descriptive follow-up studies confirm that skin infections are common among renal transplant recipients. We report the development of subcutaneous nodules among patients receiving renal transplantations from 1991 to 2009. Transplant recipients were followed by the Nephrology Unit at control visits according to the American Society Nephrology guidelines. Between 1991 to 2009, subcutaneous nodules were identified in 7 out of 774 renal transplant recipients. The male:female ratio was 5:2; median age at renal transplantation was 52 years (range 28-59). Subcutaneous nodules were identified at a median 3 years after transplantation. The 7 patients had the following diagnoses: systemic scedosporiasis (n = 1); Mycobacterium avium complex infection (n = 2) disseminated tuberculosis (n = 2) Sporothrix schenckii infection (n = 1); Trichophyton rubrum infection (n = 1). Four patients died due to sepsis from disseminated infection. Subcutaneous nodules may reflect a systemic infectious pathology. In some cases, the investigation of cutaneous lesions is important to reach a definitive diagnosis for possible future disseminated infections.

摘要

肾移植受者由于免疫抑制治疗的影响,发生感染性疾病的风险增加,且易患皮肤感染。一些长期的描述性随访研究证实,皮肤感染在肾移植受者中很常见。我们报告了1991年至2009年接受肾移植患者中皮下结节的发生情况。根据美国肾脏病学会指南,移植受者由肾脏病科在对照访视时进行随访。1991年至2009年期间,774例肾移植受者中有7例发现皮下结节。男女比例为5:2;肾移植时的中位年龄为52岁(范围28 - 59岁)。皮下结节在移植后中位3年时被发现。这7例患者有以下诊断:系统性赛多孢子菌病(n = 1);鸟分枝杆菌复合群感染(n = 2);播散性结核病(n = 2);申克孢子丝菌感染(n = 1);红色毛癣菌感染(n = 1)。4例患者因播散性感染导致的败血症死亡。皮下结节可能反映系统性感染性病理情况。在某些情况下,对皮肤病变进行检查对于明确可能未来播散性感染的诊断很重要。

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