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肾移植受者结核性心包炎所致心脏压塞

Cardiac tamponade caused by tuberculosis pericarditis in renal transplant recipients.

作者信息

Kim Jong Man, Kim Sung-Joo, Joh Jae-Won, Kwon Choon Hyuck David, Song Yong Bin, Shin Milljae, Moon Ju Ik, Jung Gum O, Choi Gyu-Seong, Kim Bok Nyeo, Lee Suk-Koo

机构信息

Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

J Korean Surg Soc. 2011 Jun;80 Suppl 1(Suppl 1):S40-2. doi: 10.4174/jkss.2011.80.Suppl1.S40. Epub 2011 Jun 17.

DOI:10.4174/jkss.2011.80.Suppl1.S40
PMID:22066081
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3205375/
Abstract

A 50-year-old male, renal transplant recipient, was admitted with fever and chest discomfort. At admission, chest radiologic finding was negative and echocardiography showed minimal pericardial effusion. After 2 days of admission, chest pain worsened and blood pressure fell to 60/40 mmHg. Emergency echocardiography showed a large amount of pericardial effusion compressing the entire heart. Pericardiocentesis was performed immediately. Mycobacterium tuberculosis was isolated from pericardial fluid. Tuberculosis pericarditis should be considered as the cause of cardiac tamponade in renal transplant recipients, even with the absence of pericardial effusion in the initial study or suggestive history.

摘要

一名50岁男性肾移植受者因发热和胸部不适入院。入院时胸部放射学检查结果为阴性,超声心动图显示心包积液极少。入院2天后,胸痛加重,血压降至60/40 mmHg。急诊超声心动图显示大量心包积液压迫整个心脏。立即进行了心包穿刺术。从心包液中分离出结核分枝杆菌。即使初始检查时无心包积液或无提示性病史,肾移植受者的心包填塞病因也应考虑为结核性心包炎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcf0/3205375/32024d60698b/jkss-80-S40-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcf0/3205375/32024d60698b/jkss-80-S40-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcf0/3205375/32024d60698b/jkss-80-S40-g001.jpg

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本文引用的文献

1
Tuberculosis in transplant recipients: diagnostic and therapeutic dilemmas.移植受者中的结核病:诊断与治疗困境
Transpl Infect Dis. 2008 Jul;10(4):229-30. doi: 10.1111/j.1399-3062.2008.00332.x.
2
Clinical features and outcome of tuberculosis in solid organ transplant recipients.实体器官移植受者结核病的临床特征与转归
Am J Med Sci. 2007 Aug;334(2):106-10. doi: 10.1097/MAJ.0b013e31812f5a4e.
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Mycobacterium tuberculosis infection in recipients of solid organ transplants.实体器官移植受者中的结核分枝杆菌感染
Clin Infect Dis. 2005 Feb 15;40(4):581-7. doi: 10.1086/427692. Epub 2005 Jan 25.
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Isolated hepatic tuberculosis in a transplanted liver.
Transpl Infect Dis. 2004 Jun;6(2):84-6. doi: 10.1111/j.1399-3062.2004.00048.x.
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Tuberculous pericarditis: optimal diagnosis and management.结核性心包炎:最佳诊断与管理
Clin Infect Dis. 2001 Oct 1;33(7):954-61. doi: 10.1086/322621. Epub 2001 Aug 22.
6
Mycobacterium tuberculosis infection in solid-organ transplant recipients: impact and implications for management.实体器官移植受者中的结核分枝杆菌感染:对管理的影响及意义
Clin Infect Dis. 1998 Nov;27(5):1266-77. doi: 10.1086/514993.
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Tuberculous pericarditis.结核性心包炎
JAMA. 1991 Jul 3;266(1):99-103.