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肾移植动脉毛霉菌病伴复发性血管破裂

Renal allograft arterial mucormycosis presenting with recurrent vascular blowout.

作者信息

Singh Vishal, Dabas A K, Singh Pulkit, Dogra Pavitra Manu, Singhal Gaurav

机构信息

Head of Department & Senior Advisor (Medicine & Nephrology), Army Hospital (R&R), Delhi Cantt, India.

Head of Department & Senior Advisor (Surgery & Vascular Surgery), Army Hospital (R&R), Delhi Cantt, India.

出版信息

Med J Armed Forces India. 2025 May-Jun;81(3):351-355. doi: 10.1016/j.mjafi.2023.04.011. Epub 2023 Jun 4.

Abstract

Infections, both traditional and opportunistic, constitute a major cause of morbidity and mortality in kidney transplant recipients. Mucorales, ubiquitous environmental fungi, is the cause for a rare but devastating opportunistic infection. Here, we describe a patient with an unusual mucor infection involving the graft kidney and the graft renal artery who, following a deceased donor kidney transplantation, presented in the early posttransplantation period with a vascular blowout and massive hemorrhage. Prompt aggressive resuscitation and surgical intervention saved his life; however, the renal allograft could not be preserved. The key to success in such a life-threatening atypical presentation includes a high index of suspicion, early recognition, and prompt therapeutic intervention.

摘要

感染,包括传统感染和机会性感染,是肾移植受者发病和死亡的主要原因。毛霉目真菌是普遍存在于环境中的真菌,是一种罕见但具有毁灭性的机会性感染的病因。在此,我们描述了一名肾移植受者,在接受尸体供肾移植后,移植肾和移植肾动脉发生了罕见的毛霉感染,在移植术后早期出现血管破裂和大量出血。迅速积极的复苏和手术干预挽救了他的生命;然而,移植肾未能保住。对于这种危及生命的非典型表现,成功的关键包括高度的怀疑指数、早期识别和及时的治疗干预。

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Renal allograft arterial mucormycosis presenting with recurrent vascular blowout.肾移植动脉毛霉菌病伴复发性血管破裂
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本文引用的文献

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Mucormycosis (zygomycosis) of renal allograft.肾移植后的毛霉病(接合菌病)。
Clin Kidney J. 2012 Dec;5(6):502-7. doi: 10.1093/ckj/sfs130. Epub 2012 Nov 8.
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Candida infections in solid organ transplantation.实体器官移植中的念珠菌感染
Am J Transplant. 2013 Mar;13 Suppl 4:220-7. doi: 10.1111/ajt.12114.
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Invasive filamentous fungal infections associated with renal transplant tourism.与肾移植旅游相关的侵袭性丝状真菌感染。
Transpl Infect Dis. 2010 Aug 1;12(4):371-4. doi: 10.1111/j.1399-3062.2010.00498.x. Epub 2010 Feb 16.
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Fungal infections in solid organ transplantation.实体器官移植中的真菌感染
Med Mycol. 2007 Jun;45(4):305-20. doi: 10.1080/13693780701200372.

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