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肝移植患者的蜂窝织炎作为播散性隐球菌病的初始表现

Cellulitis in a Liver Transplant Patient as an Initial Manifestation of Disseminated Cryptococcal Disease.

作者信息

Gomes de Sousa Marcos Davi, Bernardes Filho Fred, Barros Costa Fernandes Luís Eduardo, Guedes Leal Cássia Regina, Rocha Magalhães Cristiane, Custódio Neto da Silva Marcos Antonio, Silva Barcaui Halime

机构信息

Instituto Nacional de Infectologia Evandro Chagas (INI-Fiocruz), Universidade Estácio de Sá (UNESA), Rio de Janeiro, Brazil.

Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil.

出版信息

Case Rep Dermatol. 2016 Oct 4;8(3):250-253. doi: 10.1159/000449365. eCollection 2016 Sep-Dec.

DOI:10.1159/000449365
PMID:28101016
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5216227/
Abstract

A 50-year-old male underwent liver transplantation due to cryptogenic cirrhosis and was admitted with severe pain in the left leg as well as phlogosis. Amoxicillin/clavulanic acid was prescribed, assuming bullous erysipelas. Among the tests performed, the latex agglutination test for the sp. antigen was positive, and in both the blood culture and blister culture sp. was isolated. Daily fluconazole was started. Even though liposomal amphotericin B has been started on the fifth day of hospitalization, the patient progressed to death.

摘要

一名50岁男性因隐源性肝硬化接受肝移植，入院时左腿剧痛且伴有炎症。考虑为大疱性丹毒，遂开具阿莫西林/克拉维酸。在进行的各项检查中，针对该菌属抗原的乳胶凝集试验呈阳性，血液培养和水疱培养均分离出该菌属。开始每日使用氟康唑。尽管在住院第5天开始使用脂质体两性霉素B，但患者仍病情进展直至死亡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d51f/5216227/4d3c748b9282/cde-0008-0250-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d51f/5216227/4d3c748b9282/cde-0008-0250-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d51f/5216227/4d3c748b9282/cde-0008-0250-g01.jpg

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2
Cutaneous cryptococcosis in a patient on chronic haemodialysis.
Nefrologia. 2012;32(5):697-8. doi: 10.3265/Nefrologia.pre2012.Jun.11563.
3
Cutaneous cryptococcosis in solid organ transplant recipients: epidemiological, clinical, diagnostic and therapeutic features.实体器官移植受者的皮肤隐球菌病：流行病学、临床、诊断和治疗特征。
Eur J Dermatol. 2012 Sep-Oct;22(5):651-7. doi: 10.1684/ejd.2012.1819.
4
Cryptococcosis in solid organ transplant recipients.实体器官移植受者中的隐球菌病。
Am J Transplant. 2009 Dec;9 Suppl 4:S192-8. doi: 10.1111/j.1600-6143.2009.02911.x.
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Cryptococcal disease presenting as necrotizing cellulitis in transplant recipients.隐球菌病在移植受者中表现为坏死性蜂窝织炎。
Transpl Infect Dis. 2009 Aug;11(4):353-8. doi: 10.1111/j.1399-3062.2009.00399.x. Epub 2009 May 3.
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Serologic evidence for reactivation of cryptococcosis in solid-organ transplant recipients.实体器官移植受者中隐球菌病再激活的血清学证据。
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