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直立性低血压作为肾移植受者播散性隐球菌病的首发表现。

Orthostatic hypotension as the initial presentation of disseminated cryptococcosis in a kidney transplant recipient.

作者信息

Gough Sophie, Borgetti Scott, Fernandes Christopher R

机构信息

University of Illinois at Chicago College of Medicine, 1853 W Polk St, Chicago, IL 60612, USA.

出版信息

IDCases. 2022 Jul 11;29:e01567. doi: 10.1016/j.idcr.2022.e01567. eCollection 2022.

Abstract

BACKGROUND

Solid organ transplant recipients are immunocompromised and at risk for invasive viral, fungal, and bacterial pathogens. is the third most common invasive fungal infection in transplant recipients, and the clinical presentation of Cryptococcus neoformans infection can vary widely. Cryptococcal disease can affect the brain, lungs, skin, or vasculature, and it is frequently disseminated. Meningitis typically presents with fever, headache, and altered mental status. Solid organ transplant recipients with cryptococcosis tend to have poorer outcomes than HIV patients with cryptococcosis.

CASE PRESENTATION

In this case report, we describe the case of a 69 year-old man with a past medical history of a deceased donor kidney transplant who presented with severe orthostatic hypotension and was found to have disseminated cryptococcosis.

CONCLUSIONS

This case report emphasizes the importance of broadening the differential diagnosis in transplant recipients who present with non-specific chief concerns.

AVAILABILITY OF DATA AND MATERIALS

No datasets were used in the preparing of this manuscript. All patient information comes from the electronic health record and authors personal care of this patient.

摘要

背景

实体器官移植受者免疫功能低下,易感染侵袭性病毒、真菌和细菌病原体。隐球菌病是移植受者中第三常见的侵袭性真菌感染,新型隐球菌感染的临床表现差异很大。隐球菌病可累及脑、肺、皮肤或血管系统,且常播散。脑膜炎通常表现为发热、头痛和精神状态改变。实体器官移植受者患隐球菌病的预后往往比感染隐球菌病的艾滋病患者更差。

病例报告

在本病例报告中,我们描述了一名69岁男性患者的病例,该患者有已故供体肾移植病史,出现严重直立性低血压,被发现患有播散性隐球菌病。

结论

本病例报告强调了在以非特异性主要症状就诊的移植受者中扩大鉴别诊断范围的重要性。

数据和材料的可用性

本手稿的撰写未使用任何数据集。所有患者信息均来自电子健康记录以及作者对该患者的个人护理。

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