Thomas S, Pawar B, Fernandes D, Nayar S, George P, Cherian S
Alice Springs Hospital, Northern Territory, Australia.
Alice Springs Hospital, Northern Territory, Australia.
Transplant Proc. 2018 Dec;50(10):3943-3945. doi: 10.1016/j.transproceed.2018.06.001. Epub 2018 Jun 6.
Invasive fungal infections in solid organ transplant recipients are associated with significant morbidity and mortality. Of these fungal infections, mucormycosis presents as an aggressive, frequently fatal angioinvasive infection. Immunocompromised hosts and diabetes are important risk factors. These infections are frequently difficult to diagnose. A high index of suspicion in the appropriate setting and early, aggressive treatment with the newer antifungal agents have altered the previously grave prognosis. We present the first reported case of cavitating pulmonary mucormycosis in a renal transplant recipient caused by an unusual species of Mucorales. The patient was treated with a combination of lobectomy and antifungal treatment comprising of amphotericin B and posaconazole. He remains free of disease recurrence on monotherapy with posaconazole.
实体器官移植受者的侵袭性真菌感染与显著的发病率和死亡率相关。在这些真菌感染中，毛霉病表现为一种侵袭性强、常致命的血管侵袭性感染。免疫功能低下的宿主和糖尿病是重要的危险因素。这些感染常常难以诊断。在适当的情况下保持高度怀疑，并使用新型抗真菌药物进行早期、积极的治疗，已经改变了先前严峻的预后。我们报告了首例由一种不常见的毛霉目真菌引起的肾移植受者空洞性肺毛霉病病例。该患者接受了肺叶切除术和由两性霉素B和泊沙康唑组成的抗真菌治疗。他在接受泊沙康唑单药治疗后未出现疾病复发。
