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肾移植术后受者新型隐球菌感染的临床分析

龙成美 杨华 李新长 张钰 杨锦然

龙成美, 杨华, 李新长, 等. 肾移植术后受者新型隐球菌感染的临床分析[J]. 器官移植, 2019, 10(4): 434-438. doi: 10.3969/j.issn.1674-7445.2019.04.014
引用本文: 龙成美, 杨华, 李新长, 等. 肾移植术后受者新型隐球菌感染的临床分析[J]. 器官移植, 2019, 10(4): 434-438. doi: 10.3969/j.issn.1674-7445.2019.04.014
Long Chengmei, Yang Hua, Li Xinchang, et al. Clinical analysis of infection in recipients after renal transplantation[J]. ORGAN TRANSPLANTATION, 2019, 10(4): 434-438. doi: 10.3969/j.issn.1674-7445.2019.04.014
Citation: Long Chengmei, Yang Hua, Li Xinchang, et al. Clinical analysis of infection in recipients after renal transplantation[J]. ORGAN TRANSPLANTATION, 2019, 10(4): 434-438. doi: 10.3969/j.issn.1674-7445.2019.04.014

肾移植术后受者新型隐球菌感染的临床分析

doi: 10.3969/j.issn.1674-7445.2019.04.014
基金项目: 

江西省科技计划项目 20151BBG70069

详细信息
    作者简介:

    龙成美,男,1973年生,博士,副主任医师,研究方向为器官捐献及移植工作、肾脏病基础与临床研究,Email:ddlongchm19@163.com

    通讯作者:

    李新长,男,1966年生,学士,主任医师,研究方向为器官捐献及移植工作、肾脏病基础与临床研究,Email:lxzh863@126.com

  • 中图分类号: R617, R392.4

Clinical analysis of infection in recipients after renal transplantation

More Information
  • 摘要:   目的  分析肾移植术后患者新型隐球菌感染的临床特点。  方法  回顾性分析9例肾移植术后新型隐球菌感染受者的临床资料,包括受者的感染部位、临床表现、真菌学、组织病理学、影像学检查结果及治疗经过和转归。  结果  9例肾移植受者术后常规应用他克莫司(FK506)+吗替麦考酚酯(MMF)+泼尼松三联免疫抑制治疗。发病中位时间为术后6(1~13)年。其中单纯隐球菌性脑膜炎1例、隐球菌性脑膜炎合并隐球菌肺炎5例、单纯隐球菌肺炎2例、皮肤隐球菌病1例。隐球菌肺炎临床多表现为发热、咳嗽、咳痰、气促及胸痛等症状,胸部CT示结节、胸腔积液等。主要经肺穿刺活组织检查(活检)及肺泡灌洗液墨汁负染色确诊。隐球菌性脑膜炎患者临床表现以发热、阵发性头痛伴呕吐症状居多,主要经血培养及脑脊液墨汁负染色确诊。皮肤隐球菌病表现为右肩部包块,经皮肤活检确诊。所有患者分别给予两性霉素B、氟康唑等规范抗真菌治疗,免疫抑制剂减量治疗。9例受者中1例死亡,其余受者预后情况良好。  结论  肾移植术后受者新型隐球菌感染多发生于术后中晚期,临床症状缺乏特异性,对怀疑隐球菌病者应及时做血培养、肺穿刺活检、脑脊液等检查以确诊。规范抗真菌治疗可降低病死率。

     

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出版历程
  • 收稿日期:  2019-04-08
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2019-07-15

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