Huang Hung-Ling, Lin Chun-Yu, Chang Ya-Ting, Chen Yen-Hsu, Wu Wei-Tsung, Lu Po-Liang
Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
J Microbiol Immunol Infect. 2016 Apr;49(2):300-4. doi: 10.1016/j.jmii.2013.05.005. Epub 2013 Jul 6.
The infection rate of arteriovenous (AV) grafts is high, but fungal etiology is rare. Only five cases of graft infection due to Candida albicans (C. albicans) or C. tropicalis have been described in the literature. Herein, we report the first case of AV graft infection caused by C. glabrata. A 60-year-old woman on maintenance hemodialysis for end-stage renal disease was admitted because of intermittent fever, for 10 days. Upon physical examination, tenderness over the AV graft site was noticed. Blood culture yielded C. glabrata and her clinical symptoms improved after she was treated with micafungin for 1 month. However, C. glabrata candidemia reoccurred 5 weeks later. Cure was achieved after removal of the AV graft and anidulafungin treatment. Pus was observed in the removed graft, from which C. glabrata was isolated. The outcome of our case and patients from the literature review suggest that removal of the infected graft is important for treatment success of AV graft Candida infection.
动静脉(AV)移植物的感染率很高,但真菌病因较为罕见。文献中仅描述了5例由白色念珠菌(白色念珠菌)或热带念珠菌引起的移植物感染病例。在此,我们报告首例由光滑念珠菌引起的AV移植物感染病例。一名因终末期肾病接受维持性血液透析的60岁女性因间歇性发热10天入院。体格检查时,发现AV移植物部位有压痛。血培养检出光滑念珠菌,在接受米卡芬净治疗1个月后,她的临床症状有所改善。然而,5周后再次发生光滑念珠菌血症。在移除AV移植物并使用阿尼芬净治疗后治愈。在移除的移植物中观察到脓液,并从中分离出光滑念珠菌。我们病例的结果以及文献综述中的患者表明,移除感染的移植物对于AV移植物念珠菌感染的治疗成功至关重要。