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肝移植术后鼻上颌毛霉菌病局部应用两性霉素B脂质复合物联合标准治疗的病例报告

Association of topical amphotericin B lipid complex treatment to standard therapy for rhinomaxillary mucormycosis after liver transplantation: a case report.

作者信息

Trasmonte M V, Jiménez J D, Santiago M Á, Gálvez E, Jerez V, Pérez D, Robles M, Farje V K, Martínez P, Nieto P, Rubio J A

机构信息

Intensive Care Unit, Hospital Infanta Cristina, Badajoz, Spain.

出版信息

Transplant Proc. 2012 Sep;44(7):2120-3. doi: 10.1016/j.transproceed.2012.07.081.

Abstract

Solid organ transplantation is becoming increasingly more common in the treatment of end-stage organ failure. The advent of newer immunosuppressive protocols and refined surgical techniques has allowed therapy to become standard care. Infection is a major and frequently life-threatening complication after transplantation and the incidence of opportunistic fungal infections in organ transplant recipients ranges from 2%-50% depending on the type of organ transplanted. We present a case of rhinomaxillary form of mucormycosis infection after liver transplantation. The succession of multiple risk factors in a torpid postoperative period was a key factor in the development of this disease. Multidisciplinary management with an early diagnosis, aggressive surgery, and intravenous and topical antifungal therapy care were definitive for the eradication of infection. The goal of the present report was to show efficacious management including the association of topical treatment with amphotericin B complex lipid to standard therapy and the absence of side effects.

摘要

实体器官移植在终末期器官衰竭的治疗中越来越普遍。更新的免疫抑制方案和完善的手术技术的出现使这种治疗成为标准治疗方法。感染是移植后主要且常常危及生命的并发症,器官移植受者中机会性真菌感染的发生率在2%至50%之间,具体取决于所移植器官的类型。我们报告一例肝移植后鼻上颌部毛霉菌病感染病例。术后恢复期多种危险因素的相继出现是该疾病发生的关键因素。早期诊断、积极手术以及静脉和局部抗真菌治疗的多学科管理对于根除感染至关重要。本报告的目的是展示有效的管理方法,包括将两性霉素B复合脂质局部治疗与标准治疗相结合,且无副作用。

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