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肾移植受者同时发生球孢子菌病和暗色丝孢霉病:一例报告及文献复习

Simultaneous coccidioidomycosis and phaeohyphomycosis in a kidney transplant recipient: A case report and literature review.

作者信息

Puing Alfredo G, Couture-Cossette Antoine, Wang Aileen X, Zygourakis Corinna C, Cheng Xingxing, Stevens Bryan A, Banaei Niaz, Novoa Roberto A, Ho Dora Y, Subramanian Aruna K

机构信息

Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.

Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.

出版信息

Transpl Infect Dis. 2020 Dec;22(6):e13365. doi: 10.1111/tid.13365. Epub 2020 Jun 25.

Abstract

Advances in solid organ transplantation have improved the survival of end-stage organ disease at the expense of an increased risk for opportunistic infections. Unusual clinical presentations and the possibility of concurrent infections make diagnosing invasive fungal infection (IFI) more difficult. Here, we present a case of simultaneous vertebral infection caused by Coccidioides immitis-posadasii and subcutaneous phaeohyphomycosis due to Nigrograna mackinnonii in a kidney transplant recipient. The diagnosis of both infections required invasive procedures to obtain tissue and a high index of suspicion that more than one IFI could be present. A multidisciplinary team approach for the management of immunocompromised patients with suspected or diagnosed IFI is warranted.

摘要

实体器官移植的进展提高了终末期器官疾病患者的生存率,但代价是机会性感染风险增加。不寻常的临床表现以及并发感染的可能性使得侵袭性真菌感染(IFI)的诊断更加困难。在此,我们报告一例肾移植受者同时发生由英膜球孢子菌-波萨达斯球孢子菌引起的椎体感染和由麦氏黑粒霉引起的皮下暗色丝孢霉病的病例。两种感染的诊断都需要通过侵入性操作获取组织,并且需要高度怀疑可能存在不止一种IFI。对于疑似或确诊IFI的免疫功能低下患者,采用多学科团队方法进行管理是必要的。

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