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肺移植术后脓肿分枝杆菌感染所致肺动脉梗阻的成功积极手术及内科治疗方法

A successful aggressive surgical and medical approach to pulmonary artery obstruction due to Mycobacterium abscessus infection post lung transplantation.

作者信息

Kotecha Sakhee, Smibert Olivia C, Doi Atsuo, Gooi Julian, Morrissey Orla, Paraskeva Miranda, Snell Greg I, McGiffin David

机构信息

Lung Transplant Service, The Alfred Hospital, Melbourne, Australia.

Department of Infectious Diseases, The Alfred Hospital, Melbourne, Australia.

出版信息

Transpl Infect Dis. 2018 Apr;20(2):e12838. doi: 10.1111/tid.12838. Epub 2018 Feb 19.

Abstract

Mycobacterium abscessus infection following lung transplantation has historically been associated with poor outcomes. We report a case of bilateral lung retransplantation complicated by obstruction of the right pulmonary artery secondary to M. abscessus mycotic aneurysm. Aggressive surgical management, including reconstruction of the right pulmonary artery, was undertaken with prolonged antimicrobial therapy. Thirty-six months later, antibiotics have been discontinued and the patient has stable soft tissue chest wall disease with good graft function. Mortality and morbidity associated with M. abscessus infection is considerable but this case illustrates that with aggressive early management, outcomes may be favorable.

摘要

历史上,肺移植后脓肿分枝杆菌感染一直与不良预后相关。我们报告一例双侧肺再次移植病例,该病例因脓肿分枝杆菌霉菌性动脉瘤继发右肺动脉梗阻而变得复杂。我们采取了积极的手术治疗,包括右肺动脉重建,并进行了长期抗菌治疗。36个月后,抗生素已停用,患者的胸壁软组织疾病稳定,移植肺功能良好。与脓肿分枝杆菌感染相关的死亡率和发病率相当高,但该病例表明,通过积极的早期治疗,预后可能良好

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