Post-kidney-transplant pulmonary mucormycosis: analysis of three cases
10.3760/cma.j.issn.0254-1785.2014.06.011
- VernacularTitle:肾移植后肺毛霉病三例临床分析
- Author:
Liyu XU
;
Wenqin TONG
;
Yuwang BAO
;
Deling LU
;
Yinghao YU
;
Guoxiang LAI
- Publication Type:Journal Article
- Keywords:
Kidney transplantation;
Mucormycosis;
Pathology;
Itraconazole
- From:
Chinese Journal of Organ Transplantation
2014;35(6):361-364
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical features,radiology,diagnosis and treatment of postkidney-transplant pulmonary mucormycosis.Method Three cases of post-kidney-transplant pulmonary mucormycosis were successfully diagnosed by histopathologic examinations.The clinical features of the cases were analyzed.The patients consisted of 2 males and 1 female,aged 39 to 54 yearn All patients were subjected to renal transplantation due to uremia,one was complicated with with diabetes,and pulmonary mucormycosis occurred 6 months,2 years and 6 years after kidney transplant respectively.Fever,cough,bloody sputum and chest pain were the main clinical manifestations.Multiple irregular massive or diffuse infiltrates in the lungs were the early CT findings.In a shoot time,multiple thick-walled cavities occurred in the pulmonary lesions.Pleural effusion was found in one patient.The lung specimens of patients were obtained by CT-guided percutaneous biopsy.Result The first patiem was cured after one year therapy by hraconazole,but recurred after 8 months.The second patient had a marked effect after a 21-day therapy by Itraconazole,but died of disseminated mucor for excessive immunosuppressant against the renal transplantation rejection.The third patient also had a marked effect,and was still in follow up.Condusion The post-kidney-transplant pulmonary mucormycosis is difficult in diagnosis and treatment.CT-guided percutaneous biopsy is one of effective ways for diagnosis.Itraconazole appears to be effective in treatment of pulmonary mucormycosis.Early diagnosis and an appropriate immune ftmction are the keys to improve prognosis and reduce recurrence
