Park W, Jang M, Hwang E, Han S, Park S, Kim H, Choe M
Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
Transplant Proc. 2014;46(2):623-5. doi: 10.1016/j.transproceed.2013.12.017.
Mucormycosis is an uncommon infectious complication with fatal outcome after kidney transplantation. We describe a rare form of mucormycosis in allograft kidney. The patient was a 54-year-old man who underwent deceased-donor transplantation. The patient experienced delayed graft function and new-onset diabetes within 1 week after transplantation. Four weeks after transplantation, he was readmitted because of allograft dysfunction without fever or pain. Ultrasonography showed enlarged allograft with normal blood flow. He was received broad antibiotics for 6 days, but allograft function was not recovered. Seven days after admission, allograft biopsy was performed, and in microscopic examination, extensive necrotic areas with disseminated fungal invasion were seen, and it was identified as Rhizopus microsporus by culture and DNA analysis. With allograft nephrectomy, he was treated with amphotericin B. Despite intensive antifungal drugs after graft nephrectomy, the patient died of disseminated fungal infection.
毛霉病是肾移植后一种罕见的具有致命后果的感染性并发症。我们描述了一种同种异体移植肾中罕见的毛霉病形式。该患者为一名54岁男性,接受了尸体供肾移植。患者在移植后1周内出现移植肾功能延迟恢复和新发糖尿病。移植后4周,他因移植肾功能不全再次入院,无发热或疼痛。超声检查显示移植肾肿大,血流正常。他接受了6天的广谱抗生素治疗,但移植肾功能未恢复。入院7天后,进行了移植肾活检,显微镜检查发现广泛的坏死区域伴有播散性真菌感染,通过培养和DNA分析鉴定为微小根霉。行移植肾切除术后,他接受了两性霉素B治疗。尽管在移植肾切除术后使用了强化抗真菌药物,但患者仍死于播散性真菌感染。