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肺移植患者中首例布鲁氏菌肺炎病例报告及文献综述

First Case of Brucella Pneumonia in a Lung Transplant Patient: Case Report and Review of the Literature.

作者信息

Abed Abdulaziz H, Almaghrabi Reem S, Nizami Imran

机构信息

Medicine and Surgery, Alfaisal University College of Medicine, Riyadh, SAU.

Infectious Diseases, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU.

出版信息

Cureus. 2020 Jun 21;12(6):e8733. doi: 10.7759/cureus.8733.

DOI:10.7759/cureus.8733
PMID:32596091
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7308817/
Abstract

Brucella is one of the most common zoonotic diseases worldwide. It is endemic in the Mediterranean basin. Brucella pneumonia is a rare complication of brucellosis that can present with a variety of clinical and radiological manifestations. It was described only once previously in the setting of solid organ transplant. A 32-year-old female from Saudi Arabia with cystic fibrosis and bronchiectasis presented five weeks after a bilateral lung transplant with fever and cough. Investigation showed high inflammatory markers in addition to a pulmonary infiltrate in the chest imaging. All microbiological workups were negative including bronchoalveolar lavage cultures. Brucella serology was positive and she was started on anti-Brucella therapy which resulted in complete resolution of her symptoms and radiological changes. This case demonstrates an unusual presentation of Brucellosis. It highlights the importance of epidemiology in evaluating post-transplant infections. We reviewed and summarized the literature on brucellosis post solid organ transplant and the various treatment regimens for Brucella pneumonia. This is the first case report of Brucella pneumonia in a lung transplant patient. Brucella is a rare complication post solid organ transplant but it has a good prognosis.

摘要

布鲁氏菌病是全球最常见的人畜共患病之一。在地中海盆地呈地方性流行。布鲁氏菌肺炎是布鲁氏菌病一种罕见的并发症,可表现出多种临床和影像学表现。此前仅在实体器官移植病例中被描述过一次。一名来自沙特阿拉伯的32岁患有囊性纤维化和支气管扩张的女性在双侧肺移植术后五周出现发热和咳嗽。检查显示除胸部影像学有肺部浸润外,炎症指标也很高。所有微生物学检查结果均为阴性,包括支气管肺泡灌洗培养。布鲁氏菌血清学检查呈阳性,她开始接受抗布鲁氏菌治疗,症状和影像学改变完全消退。该病例展示了布鲁氏菌病的一种不寻常表现。它凸显了流行病学在评估移植后感染中的重要性。我们回顾并总结了实体器官移植后布鲁氏菌病及布鲁氏菌肺炎各种治疗方案的文献。这是首例肺移植患者发生布鲁氏菌肺炎的病例报告。布鲁氏菌病是实体器官移植后罕见的并发症,但预后良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4429/7308817/6807c0901e25/cureus-0012-00000008733-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4429/7308817/b85aa4b6575b/cureus-0012-00000008733-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4429/7308817/7d420fdc0984/cureus-0012-00000008733-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4429/7308817/2c90db762235/cureus-0012-00000008733-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4429/7308817/6807c0901e25/cureus-0012-00000008733-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4429/7308817/b85aa4b6575b/cureus-0012-00000008733-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4429/7308817/7d420fdc0984/cureus-0012-00000008733-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4429/7308817/2c90db762235/cureus-0012-00000008733-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4429/7308817/6807c0901e25/cureus-0012-00000008733-i04.jpg

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本文引用的文献

1
Brucellosis in renal transplant recipients: a comparative review of 5 cases.肾移植受者中的布鲁氏菌病:5例病例的比较性综述
BMJ Case Rep. 2018 Jul 30;2018:bcr-2018-225865. doi: 10.1136/bcr-2018-225865.
2
Brucellosis After Cardiac Transplantation.心脏移植术后布鲁菌病。
Ann Thorac Surg. 2019 Jan;107(1):e31-e32. doi: 10.1016/j.athoracsur.2018.05.054. Epub 2018 Jun 19.
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Human-to-human transmission of Brucella - a systematic review.布鲁氏菌的人际传播——一项系统综述
Trop Med Int Health. 2017 May;22(5):539-546. doi: 10.1111/tmi.12856. Epub 2017 Mar 9.
4
Treatment of pulmonary brucellosis: a systematic review.肺型布鲁氏菌病的治疗:一项系统综述
Expert Rev Anti Infect Ther. 2017 Jan;15(1):33-42. doi: 10.1080/14787210.2017.1254042. Epub 2016 Nov 10.
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Pulmonary Involvement in Brucellosis, a Rare Complication of Renal Transplant: Case Report and Brief Review.布鲁氏菌病累及肺部,肾移植的一种罕见并发症:病例报告及简要综述
Exp Clin Transplant. 2018 Dec;16(6):757-760. doi: 10.6002/ect.2015.0324. Epub 2016 May 17.
6
Brucella infection in a child with progressive familial intrahepatic cholestasis type 2 who had undergone liver transplantation.一名患有2型进行性家族性肝内胆汁淤积症且已接受肝移植的儿童发生布鲁氏菌感染。
Pediatr Transplant. 2015 Sep;19(6):E146-8. doi: 10.1111/petr.12555. Epub 2015 Jul 6.
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Brucellosis infection in an adult liver transplant recipient.一名成年肝移植受者的布鲁氏菌病感染
Transpl Infect Dis. 2014 Jun;16(3):516-8. doi: 10.1111/tid.12204. Epub 2014 Mar 26.
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Brucellosis in a renal transplant recipient.一名肾移植受者的布鲁氏菌病
Transpl Infect Dis. 2013 Oct;15(5):E191-5. doi: 10.1111/tid.12125. Epub 2013 Aug 27.
9
Respiratory system involvement in brucellosis: the results of the Kardelen study.布鲁氏菌病呼吸系统受累:Kardelen 研究结果。
Chest. 2014 Jan;145(1):87-94. doi: 10.1378/chest.13-0240.
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Relapsing brucellosis after liver transplantation in a child: what is the appropriate regimen and duration of therapy?一名儿童肝移植后复发性布鲁氏菌病:合适的治疗方案及疗程是怎样的?
Transplantation. 2013 Jul 27;96(2):e6-7. doi: 10.1097/TP.0b013e318296fd1a.