Jacob E T, Ziskind Z, Nativ O, Shabtai M
Isr J Med Sci. 1985 Jul;21(7):613-6.
A patient with severe pulmonary nocardiosis occurring in the early posttransplant period is presented. Three outstanding features characterized this case: 1) the failure to diagnose this rare opportunitistic pathogen by conventional detection methods necessitated open lung biopsy; 2) the initiation of trimethoprim-sulphamethoxazole therapy resulted in a dramatic clinical response; and 3) an allograft recipient with a low immunological response contracted nocardiosis. His immune status became apparent following pretransplant donor-specific blood transfusion tests, unresponsiveness to third-party transfusion and graft tolerance permitting the permanent withdrawal of azathioprine without graft function impairment.
本文介绍了一名在移植后早期发生严重肺诺卡菌病的患者。该病例有三个突出特点：1）传统检测方法未能诊断出这种罕见的机会性病原体，因此需要进行开胸肺活检；2）开始使用复方新诺明治疗后，临床反应显著；3）一名免疫反应较低的同种异体移植受者感染了诺卡菌病。他的免疫状态在移植前供体特异性输血试验、对第三方输血无反应以及移植物耐受后变得明显，这使得在不损害移植物功能的情况下可以永久停用硫唑嘌呤。
