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肺移植术后皮炎外瓶霉致侵袭性真菌感染 1 例并文献复习

Invasive Fungal Infection Caused by Exophiala dermatitidis in a Patient After Lung Transplantation: Case Report and Literature Review.

机构信息

Division of Clinical Microbiology, Department of Laboratory Medicine, General Hospital of Vienna, Medical University of Vienna, Vienna, Austria.

Institute for Hygiene and Applied Immunology, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.

出版信息

Mycopathologia. 2019 Feb;184(1):107-113. doi: 10.1007/s11046-018-0275-4. Epub 2018 Jun 11.

Abstract

This report describes a case of invasive Exophiala dermatitidis infection after double lung transplantation in a 76-year-old man. After thoracotomy, the patient's wound showed dehiscence with purulent secretion. The black yeast was isolated from cultures taken from the wound, and species identification was confirmed by sequence analysis of the internal transcribed spacer (ITS-S2) region. The results of the susceptibility testing showed voriconazole as the most active drug. Despite adaptation of the antifungal therapy the clinical condition worsened, and the patient died. In addition, we evaluated the fungicidal activity of antiseptics towards E. dermatitidis and aimed to provide a brief literature review of previously reported infections caused by this rare fungus. To the best of our knowledge, this is the first report of a rapidly progressing invasive fungal infection with E. dermatitidis originating from a colonized wound after lung transplantation.

摘要

本报告描述了一例 76 岁男性在接受双肺移植后发生侵袭性外瓶霉感染的病例。患者在剖胸术后出现伤口裂开并伴有脓性分泌物。从伤口培养物中分离出黑色酵母,并通过内部转录间隔区(ITS-S2)区域的序列分析确认了种属鉴定。药敏试验结果显示伏立康唑为最有效的药物。尽管抗真菌治疗进行了调整,但临床状况仍恶化,患者死亡。此外,我们评估了防腐剂对皮炎外瓶霉的杀菌活性,并旨在提供对此罕见真菌引起的先前报道感染的简要文献回顾。据我们所知,这是首例肺移植后来源于定植伤口的快速进展性侵袭性真菌感染的报道。

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