One case of gastrointestinal mucor infection secondary to severe pneumonia after renal transplantation and literature review
10.3760/cma.j.cn421203-20190802-00313
- VernacularTitle:肾移植术后消化道毛霉菌感染继发重症肺炎一例并文献复习
- Author:
Yuan DU
1
;
Jianfeng LI
;
Yehong YAN
;
Jiansheng XIAO
;
Hao WAN
;
Feixiang WU
;
Huangbing ZHANG
Author Information
1. 南昌大学第一附属医院 330000
- From:
Chinese Journal of Organ Transplantation
2020;41(5):301-304
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical diagnosis and treatment of invasive gastrointestinal fungal infection plus pulmonary infection after renal transplantation.Methods:Clinical data were analyzed retrospectively for one patient with invasive fungal infection plus pulmonary infection after renal transplantation. The middle-aged female recipient underwent allogeneic kidney transplantation due to end-stage uremia. After successful kidney transplantation, there was postprandial epigastric pain not relieved by proton pump inhibitor. Gastroscopy after admission suggested that the nature of gastric mucosal lesions was to be determined. Pathological examination and special staining confirmed mucor.Results:After clarifying her conditions, the doses of such immunosuppression as tacrolimus, mycophenolate mofetil and prednisone were tapered and discontinued when necessary and using amphotericin B liposome plus posaconazole alleviated the digestive tract symptoms. Chest tightness, fever, shortness of breath after activities hinted at pulmonary infection after renal transplantation. Treatment was guided by the results of sputum culture.Conclusions:Mucor infection is rare in digestive tract complicated with pulmonary infection after renal transplantation. Clinicians should actively search for etiological evidence, seek multidisciplinary consultations for a definite diagnosis and provide empirical anti-infection treatments. Due attention is to be paid for double infection caused by anti-infection treatments and anti-infection treatment strategy should be timely adjusted and the dosage of immunosuppressant based upon immune monitoring.
