Gonzales Zamora Jose Armando, Varadarajalu Yogeeta
Division of Infectious Diseases. Department of Medicine. University of Miami. Miller School of Medicine, Miami 33136, FL, USA.
IDCases. 2019 Jun 13;17:e00576. doi: 10.1016/j.idcr.2019.e00576. eCollection 2019.
A 42-year-old woman with history of heart failure status post orthotopic heart transplant and end stage renal disease presented to the hospital with decompensated heart failure that progressed to cardiogenic shock. She underwent a new orthotopic heart transplant and cadaveric donor kidney transplant. Three weeks later, she experienced right facial droop and right upper extremity weakness. Computed tomography showed a left frontal cortical lesion with vasogenic edema and a central hemorrhagic component. Given the concern for an angioinvasive mold infection, she was started on voriconazole and amphotericin B. Brain biopsy was performed and histopathology revealed septated hyphae with acute angle branching. Mycology culture isolated Curvularia sp. Unfortunately, her mental status deteriorated with subsequent development of multiorgan failure that led to death.
一名42岁女性，有原位心脏移植病史及终末期肾病，因失代偿性心力衰竭进展为心源性休克入院。她接受了再次原位心脏移植及尸体供肾移植。三周后，她出现右侧面部下垂及右上肢无力。计算机断层扫描显示左额叶皮质病变，伴有血管源性水肿及中央出血成分。鉴于担心血管侵袭性霉菌感染，她开始接受伏立康唑和两性霉素B治疗。进行了脑活检，组织病理学显示有分隔的菌丝，呈锐角分支。真菌培养分离出弯孢霉菌。不幸的是，她的精神状态恶化，随后出现多器官功能衰竭并导致死亡。
