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肝移植受者中由拟茎点霉引起的孤立性肺部镰刀菌病:病例报告及文献复习。

Isolated pulmonary fusariosis caused by Neocosmospora pseudensiformis in a liver transplant recipient: A case report and review of the literature.

机构信息

Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

出版信息

Transpl Infect Dis. 2020 Dec;22(6):e13344. doi: 10.1111/tid.13344. Epub 2020 Jun 16.

Abstract

Neocosmospora pseudensiformis (formerly Fusarium pseudensiforme) is a hyaline mold in the Fusarium solani species complex that has been changed to the genus Neocosmospora. Invasive fusariosis is a rare fungal infection in solid organ transplantation. The most commonly reported manifestation of invasive fusariosis in this setting is localized cutaneous fusariosis. Here, we present the first case report of isolated N pseudensiformis pulmonary infection in a patient with non-alcoholic steatohepatitis cirrhosis who underwent orthotopic liver transplantation. A 67-year-old Thai woman developed acute graft rejection, dyspnea, and pulmonary consolidation 6 months after liver transplantation. N pseudensiformis was isolated from her sputum, and her clinical symptoms were improved with voriconazole treatment. However, she succumbed to Acinetobacter baumannii hospital-acquired pneumonia and acute coronary syndrome with cardiogenic shock after 10 days of treatment.

摘要

新拟青霉(Neocosmospora pseudensiformis)(曾为拟茎点霉 Fusarium pseudensiforme)是镰孢 Solani 种复合体中的一种透明霉菌,已被归入新拟青霉属。侵袭性镰刀菌病是实体器官移植中一种罕见的真菌感染。在这种情况下,侵袭性镰刀菌病最常报告的表现是局部皮肤镰刀菌病。在这里,我们报告了首例非酒精性脂肪性肝炎肝硬化患者在接受原位肝移植后发生孤立性新拟青霉肺部感染的病例。一名 67 岁的泰国女性在肝移植后 6 个月时出现急性移植物排斥、呼吸困难和肺部实变。从她的痰液中分离出新拟青霉,伏立康唑治疗后其临床症状得到改善。然而,在治疗 10 天后,她因获得性鲍曼不动杆菌肺炎和急性冠状动脉综合征合并心源性休克而死亡。

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