Clinical Characteristics and Diagnostic and Therapeutic Strategies of Severe Cytomegaloviral Pneumonia after Kidney Transplantation
- VernacularTitle:肾移植术后巨细胞病毒性重症肺炎的发病特点及其诊治策略
- Author:
Wenxiong LI
;
Huide CHEN
;
Xiaowen WANG
;
Song ZHAO
;
Yue ZHENG
- Publication Type:Journal Article
- Keywords:
Cytomegalovirus;
Pneumonia;
Acute respiratory distress syndrome;
Kidney transplantation
- From:
Chinese Journal of Nosocomiology
2006;0(08):-
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To summarize the clinical characteristics,diagnositic and therapeutic strategies of severe cytomegaloviral (CMV) pneumonia after kidney transplantation. METHODS To analyze retrospectively pertinent clinical information of 6 cases of severe cytomegaloviral pneumonia after kidney transplantation, including developing process of disease, clinical manifestation of pre-and post-hospitalization ,various assistant examination,therapeutic procedures and prognosis. RESULTS 6 cases had similar characters of episode as follows:CMV pneumonia occurred after 1～3 months after kidney transplantation. Major clinical symptoms included fever, coughing,few sputum without obvious manifestation of breathholding.Peripheral white blood cell was normal or less than normal range, serum CMVpp65 was finally positive during hospital stay. Radiological image of the lung presented inflammatory infiltration and obvious interstitial lesion after 7～10 days of fever, which went worse rapidly. Renal function descended with deterioration of pulmonary infection. All of patients had been treated with multiple antibiotics,glucocorticoid and mechanical ventilation, Etiological diagnosis of the 3th～6th cases were earlier than 1th～2th cases , the 3th～6th cases who finally survived were treated with longer and higher doses of antivirus and glucocorticoid, than 1th～2th cases who died of refractory hypoxemia and acute renal failure during hospital stay. CONCLUSIONS Severe cytomegaloviral pneumonia had similar clinical characteristics of episode. early diagnosis of etiology,continuous application of antivirus and glucocorticoid were crucial for Severe cytomegaloviral pneumonia after kidney transplantation.
