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肾移植受者中供体来源的致死性类圆线虫重度感染

Donor-derived fatal hyperinfection strongyloidiasis in renal transplant recipient.

作者信息

Cipriano Ana, Dias Rita, Marinho Ricardo, Correia Sofia, Lopes Virgínia, Cardoso Teresa, Aragão Irene

机构信息

Infectious Disease Department, Centro Hospitalar do Porto, Portugal.

Internal Medicine Department, Centro Hospitalar do Porto, Portugal.

出版信息

IDCases. 2020 Jan 16;19:e00703. doi: 10.1016/j.idcr.2020.e00703. eCollection 2020.

Abstract

is a nematode, endemic in tropical and subtropical areas. Strongyloidiasis has been reported in recipients of hematopoietic stem cells, kidney, liver, heart, intestine, and pancreas, eventually presenting as disseminated strongyloidiasis and hyperinfection syndrome (SHS) which is associated with high mortality. We report one case of a recent renal transplant recipient, who presented with gastrointestinal and respiratory symptoms, evolving into shock. The identification of in the bronchoalveolar lavage (BAL) lead us to the diagnosis of SHS. Treatment with subcutaneous ivermectin was started, however the patient did not survive. Retrospective serum donor analysis allowed us to identify the donor as the source of infection.

摘要

是一种线虫,在热带和亚热带地区流行。造血干细胞、肾脏、肝脏、心脏、肠道和胰腺移植受者中曾有过类圆线虫病的报道,最终表现为播散性类圆线虫病和高感染综合征(SHS),这与高死亡率相关。我们报告一例近期肾移植受者病例,该患者出现胃肠道和呼吸道症状,进而发展为休克。在支气管肺泡灌洗(BAL)中发现 使我们得以诊断高感染综合征。开始皮下注射伊维菌素进行治疗,但患者未能存活。回顾性血清供体分析使我们确定供体为感染源。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3af8/6992991/39a2fe9d88c0/gr1.jpg

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