Stas K J, Louwagie P G, Van Damme B J, Coosemans W, Waer M, Vanrenterghem Y F
Department of Nephrology, University Hospital Gasthuisberg, Leuven, Belgium.
Transpl Int. 1996;9(6):600-2. doi: 10.1007/BF00335563.
We report the first case of zygomycosis by Absidia corymbifera, only localized in an unrelated living donor kidney was bought and transplanted in India. Zygomycosis was diagnosed 2.5 months post-transplantation, in the clinical setting of rapid transplant failure, following an episode of cytomegalovirus (CMV) colitis, CMV nephritis, and acute rejection. Treatment consisted of transplantectomy. One year later, the patient is doing well, without clinical or serological evidence of persistent mycotic or virological infections. We speculate that this isolated mycotic infection originated with the donor or was due to the poor hygienic conditions in the operating theater or surgical ward. Another possibility is that this isolated renal involvement resulted from a subclinical pulmonary infection with hematogenous dissemination to the kidney in a manner comparable to renal tuberculosis. The patient received no amphotericin and was cured with transplantectomy alone.
我们报告了首例由伞枝犁头霉引起的接合菌病病例,该病例仅局限于在印度购买并移植的一名非亲属活体供肾。接合菌病在移植后2.5个月被诊断出来,处于快速移植失败的临床背景下,此前发生了巨细胞病毒(CMV)结肠炎、CMV肾炎和急性排斥反应。治疗包括肾切除术。一年后,患者情况良好,没有持续真菌或病毒感染的临床或血清学证据。我们推测这种孤立的真菌感染源于供体,或归因于手术室或外科病房卫生条件差。另一种可能性是,这种孤立的肾脏受累是由亚临床肺部感染经血行播散至肾脏所致,其方式与肾结核类似。该患者未接受两性霉素治疗,仅通过肾切除术治愈。