Hull University Teaching Hospitals NHS Trust, Hull, East Riding of Yorkshire, UK
Nephrology, Hull University Teaching Hospitals NHS Trust, Hull, East Riding of Yorkshire, UK.
BMJ Case Rep. 2024 Sep 18;17(9):e260095. doi: 10.1136/bcr-2024-260095.
() is a member of the rapidly growing non-tuberous mycobacteria and can cause disseminated tissue infection, particularly, in the limbs. We reviewed medical records of two kidney transplant patients. We describe their background disease and transplantation details, with the use of immunosuppressive medication. We also discuss the presentation of infection and treatment. Both patients received deceased brain-dead donor kidney transplants for end-stage kidney disease. Both developed cutaneous manifestations of , progressing to disseminated infections. Case 1 was on low-dose prednisolone (2 mg) and tacrolimus, whereas, case 2 received varying doses of prednisolone (5-40 mg) and sirolimus. Antibiotics advised by infectious disease specialists were initiated within a month of skin lesion appearance. Effective treatment involved a combination of antibiotics such as clarithromycin, azithromycin, linezolid and tigecycline. These cases underline the efficacy of clarithromycin and azithromycin as long-term antibiotic treatment, with linezolid and tigecycline for management of acute dissemination.
() 是快速生长的非结核分枝杆菌的一员，可引起播散性组织感染，特别是在四肢。我们回顾了两名肾移植患者的病历。我们描述了他们的基础疾病和移植细节，以及免疫抑制药物的使用情况。我们还讨论了 感染的表现和治疗方法。两名患者均因终末期肾病接受了脑死亡供体的肾脏移植。两人均出现皮肤表现，进展为播散性感染。病例 1 接受低剂量泼尼松龙（2 毫克）和他克莫司治疗，而病例 2接受了不同剂量的泼尼松龙（5-40 毫克）和西罗莫司治疗。传染病专家建议的抗生素在皮肤损伤出现后一个月内开始使用。有效的治疗包括联合使用抗生素，如克拉霉素、阿奇霉素、利奈唑胺和替加环素。这些病例强调了克拉霉素和阿奇霉素作为长期抗生素治疗的有效性，以及利奈唑胺和替加环素用于急性播散性感染的管理。
