Gullberg R M, Quintanilla A, Levin M L, Williams J, Phair J P
Rev Infect Dis. 1987 Mar-Apr;9(2):369-75. doi: 10.1093/clinids/9.2.369.
A case of recurrent, disseminated sporotrichosis in a renal transplant recipient is reported in which two joints, the skin, and the central nervous system were involved. The disease recurred both eight months and three years after the initial treatment with amphotericin B. The second course of therapy with amphotericin B required systemic and intraarticular administration of the drug. The third course of therapy included systemic and intrathecal administration. The function of the cadaveric transplanted kidney was maintained throughout the first recurrence of disease by careful reduction of immunosuppressive therapy and attention to the level of antifungal therapy. The kidney could not be salvaged after the second recurrence because of continued amphotericin B nephrotoxicity; however, the patient was cured of his infection. Sporothrix (Sporotrichum) schenckii may be a difficult organism to eradicate in chronically immunosuppressed patients, but the disease it causes may be successfully treated with aggressive systemic therapy.
本文报告了一例肾移植受者复发性播散性孢子丝菌病，累及两个关节、皮肤和中枢神经系统。在用两性霉素B初始治疗后8个月和3年，疾病均复发。两性霉素B的第二个疗程需要全身和关节内给药。第三个疗程包括全身和鞘内给药。在疾病首次复发期间，通过谨慎减少免疫抑制治疗并关注抗真菌治疗水平，尸体移植肾的功能得以维持。第二次复发后，由于两性霉素B持续的肾毒性，肾脏无法挽救；然而，患者的感染得以治愈。申克孢子丝菌在慢性免疫抑制患者中可能是一种难以根除的病原体，但通过积极的全身治疗，其所引起的疾病可以得到成功治疗。
