Herrera Sabina, Pavone Paolo, Kumar Deepali, Singer Lianne, Humar Atul, Chaparro Cecilia, Keshavjee Shaf, Husain Shahid, Rotstein Coleman
Immunocompromised Host Infectious Diseases Service, Division of Infectious Diseases, Department of Medicine, and the Multi-Organ Transplant Program, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Lung Transplant Program of the Multi- Organ Transplant Program, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Med Mycol Case Rep. 2019 Mar 25;24:41-43. doi: 10.1016/j.mmcr.2019.03.004. eCollection 2019 Jun.
spp. are common colonizers of the oral mucosa and respiratory tract in lung transplant recipients. Although thought to be non-pathogenic in most cases, donor derived infections related to Candida spp. have been described. Among the manifestations of invasive candidiasis, chronic meningitis is one of the rarest and one of the most challenging to diagnose, due to the indolence of the disease and the low yield of the CSF cultures. It is associated with severe morbidity and a high mortality. Fungal PCR and BD glucan assays can be assistance in its diagnosis, although these tests are not widely available. We report a case of a possible donor derived infection in a lung transplant recipient, who initially presented with empyema that was treated successfully, but subsequently developed chronic meningitis. Diagnosis was delayed due to the low yield of CSF cultures, and was confirmed with fungal PCR and BD glucan assay.
念珠菌属是肺移植受者口腔黏膜和呼吸道的常见定植菌。尽管在大多数情况下被认为是非致病性的，但与念珠菌属相关的供体源性感染已有报道。在侵袭性念珠菌病的表现中，慢性脑膜炎是最罕见且最难诊断的病症之一，这是由于该疾病进展缓慢且脑脊液培养阳性率低。它与严重的发病率和高死亡率相关。真菌聚合酶链反应（PCR）和BD葡聚糖检测有助于其诊断，尽管这些检测方法尚未广泛应用。我们报告一例肺移植受者可能发生供体源性感染的病例，该患者最初表现为脓胸，经成功治疗，但随后发展为慢性脑膜炎。由于脑脊液培养阳性率低，诊断延迟，最终通过真菌PCR和BD葡聚糖检测得以确诊。
