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器官移植受者并发隐球菌性脑膜炎和免疫重建综合征(IRIS)时,皮质类固醇治疗单眼盲:病例报告。

Reversal of uniocular blindness with corticosteroids in a solid organ transplant recipient with cryptococcal meningitis and immune reconstitution syndrome (IRIS): A case report.

机构信息

Department of Infectious Diseases AIG Hospitals, Gachibowli, Hyderabad 500032, India.

Department of Nephrology and Renal Transplant, AIG Hospitals, Tower A, 1st floor, Gachibowli, Hyderabad 500032, India.

出版信息

J Mycol Med. 2023 Aug;33(3):101406. doi: 10.1016/j.mycmed.2023.101406. Epub 2023 May 13.

Abstract

Cryptococcal meningitis is a life-threatening infection commonly seen in patients with advanced HIV infection and solid organ transplant recipients. We report a case of cryptococcal meningitis with immune reconstitution syndrome (IRIS) who presented to us with a headache and complete loss of vision in the left eye. He was managed with antifungals and a short course of steroids, and he regained vision completely. In the hospital, he developed complications including tacrolimus toxicity, fluconazole-induced QT prolongation, and flucytosine-induced thrombocytopenia. Our case demonstrates the importance of a multidisciplinary approach in the management of complex cases like cryptococcal meningitis in solid organ transplant recipients.

摘要

隐球菌性脑膜炎是一种危及生命的感染,常见于晚期 HIV 感染和实体器官移植受者。我们报告了一例免疫重建综合征(IRIS)合并隐球菌性脑膜炎的病例,该患者以头痛和左眼完全失明就诊。他接受了抗真菌药物和短期类固醇治疗,视力完全恢复。住院期间,他出现了多种并发症,包括他克莫司毒性、氟康唑引起的 QT 间期延长和氟胞嘧啶引起的血小板减少症。我们的病例表明,在管理实体器官移植受者的隐球菌性脑膜炎等复杂病例时,多学科方法的重要性。

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