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肾、心脏和肝脏移植受者非结核分枝杆菌感染

Infections due to nontuberculous mycobacteria in kidney, heart, and liver transplant recipients.

作者信息

Patel R, Roberts G D, Keating M R, Paya C V

机构信息

Division of Infectious Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905.

出版信息

Clin Infect Dis. 1994 Aug;19(2):263-73. doi: 10.1093/clinids/19.2.263.

Abstract

Infections due to nontuberculous mycobacteria (NTM) in solid-organ transplant recipients are infrequent but may be a major cause of morbidity. We describe four cases of NTM infection in solid-organ transplant recipients. The manifestations included a nodule secondary to Mycobacterium kansasii infection in a heart transplant recipient, a cutaneous lesion and a pulmonary nodule secondary to M. kansasii infection in a renal transplant recipient, tenosynovitis secondary to Mycobacterium chelonae infection in a renal transplant recipient, and cutaneous lesions secondary to M. chelonae infection in a liver transplant recipient. We also summarize previously reported cases of NTM infections in solid-organ transplant recipients; common manifestations of NTM infections in solid-organ transplant recipients include cutaneous lesions of the extremities, tenosynovitis, and joint infection. Histopathologic examination of aspirates or biopsy specimens from involved areas and staining and culture for mycobacteria are essential for diagnosis. Treatment of NTM infection most commonly involves surgery, reduction in doses of immunosuppressive medications, and/or therapy with antimycobacterial medications; these treatments are often associated with a good outcome.

摘要

实体器官移植受者非结核分枝杆菌(NTM)感染并不常见,但可能是发病的主要原因。我们描述了4例实体器官移植受者的NTM感染病例。表现包括1例心脏移植受者因堪萨斯分枝杆菌感染出现的结节、1例肾移植受者因堪萨斯分枝杆菌感染出现的皮肤病变和肺结节、1例肾移植受者因龟分枝杆菌感染出现的腱鞘炎以及1例肝移植受者因龟分枝杆菌感染出现的皮肤病变。我们还总结了先前报道的实体器官移植受者NTM感染病例;实体器官移植受者NTM感染的常见表现包括四肢皮肤病变、腱鞘炎和关节感染。对受累部位的抽吸物或活检标本进行组织病理学检查以及分枝杆菌染色和培养对诊断至关重要。NTM感染的治疗通常包括手术、减少免疫抑制药物剂量和/或抗分枝杆菌药物治疗;这些治疗通常预后良好。

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