Hellman R N, Hinrichs J, Sicard G, Hoover R, Golden P, Hoffsten P
Arch Intern Med. 1981 Jan;141(1):128-30.
Symptomatic cryptococcal pyelonephritis, meningitis, and disseminated cryptococcosis are described in a renal cadaver transplant recipient who subsequently died of Klebsiella pneumoniae sepsis. The presence of cryptococcuria and a subsequent positive CSF India ink stain led to the initial diagnosis of disseminated cryptococcosis. Therapy with 0.511 g of amphotericin B and 112.5 g of flucytosine for four weeks did not eradicate Cryptococcus from the kidney and was associated with hepatotoxicity. The importance of urinary examination and culture for C neoformans is emphasized. Cryptococcal pyelonephritis should be considered in the differential diagnosis of allograft rejection in the renal transplant patient.
一名肾移植受者出现了有症状的隐球菌性肾盂肾炎、脑膜炎和播散性隐球菌病，该受者随后死于肺炎克雷伯菌败血症。隐球菌尿的出现以及随后脑脊液印度墨汁染色阳性导致了播散性隐球菌病的初步诊断。使用0.511克两性霉素B和112.5克氟胞嘧啶治疗四周未能根除肾脏中的隐球菌，且出现了肝毒性。强调了对新型隐球菌进行尿液检查和培养的重要性。在肾移植患者中，隐球菌性肾盂肾炎应被纳入同种异体移植排斥反应鉴别诊断的考虑范围。
