Wong J Y, Chambers A L, Fuller J, Lacson A, Mullen J, Lien D, Humar A
University of Alberta, Edmonton, AB, Canada.
Pediatr Transplant. 2014 Aug;18(5):E169-73. doi: 10.1111/petr.12294. Epub 2014 Jun 14.
Fungal respiratory infections in patients with CF are a significant concern both pre- and post-lung transplantation (LTx). Fungal infection is associated with increased mortality post-LTx, and in the past decade, the prevalence of fungal colonization in Canadian pediatric patients with CF has increased. The emergence of novel fungal pathogens is particularly challenging to the transplant community, as little is known regarding their virulence and optimal management. We present a case of a successful double-lung transplant in a pediatric patient with CF who was infected pretransplantation with a novel yeast, Blastobotrys rhaffinosifermentans. This patient was treated successfully with aggressive antifungal therapy post-transplantation, followed by extended fungal prophylaxis. The significance of fungal colonization and infection in children with CF pre- and post-LTx is reviewed.
囊性纤维化（CF）患者的真菌性呼吸道感染在肺移植（LTx）前后都是一个重大问题。真菌感染与LTx后死亡率增加相关，在过去十年中，加拿大CF儿科患者的真菌定植患病率有所上升。新型真菌病原体的出现对移植界尤其具有挑战性，因为对其毒力和最佳治疗方法知之甚少。我们报告了一例CF儿科患者成功进行双肺移植的病例，该患者在移植前感染了一种新型酵母菌——嗜糖博伊丁酵母。该患者在移植后接受了积极的抗真菌治疗，并进行了延长的真菌预防，治疗成功。本文综述了CF儿童LTx前后真菌定植和感染的重要性。
