Clinical analysis ofnocardia infection in lung transplant recipient: a report of five cases
10.3760/cma.j.cn421203-20200303-00055
- VernacularTitle:肺移植受者诺卡菌感染5例临床分析
- Author:
Qiaoyan LIAN
1
;
Ao CHEN
;
Xin XU
;
Bing WEI
;
Danxia HUANG
;
Minting KUANG
;
Yuhang CAI
;
Jianxing HE
;
Chunrong JU
Author Information
1. 广州医科大学附属第一医院 广州呼吸健康研究院 呼吸疾病国家重点实验室
- Keywords:
Lung transplantation;
Pulmonary infection;
Nocardia
- From:
Chinese Journal of Organ Transplantation
2021;42(7):417-421
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical manifestations and imaging features of nocardia infection (NI) after lung transplantation and boost the diagnosis and treatment of NI.Methods:From January 2018 to December 2019, basic profiles, clinical manifestations, laboratory examinations, imaging features and treatment outcomes of 5 lung transplant recipients with a diagnosis of NF were retrospectively analyzed and summarized with the relevant literatures. There were 4 males and 1 female with a median age of 66(26-69) years. 3 patients were single-lung transplantation, 2 patients were bilateral-lung transplantation. The median time from an initial diagnosis of NI to lung transplant surgery was 6(5-19) months. Common symptoms included fever, cough with yellow phlegm and shortness of breath. Laboratory findings showed lymphopenia, significantly high C-reactive protein levels, a slight elevation of procalcitonin, hypoproteinemia and anemia. The major manifestations of high-resolution computed tomography (CT) included multiple nodules, consolidation, cavitation and pleural effusion.Results:Five strains of N. farcinica were identified from bloodstream infection ( n=2) and pulmonary infection ( n=3). After with a combined therapy of two sensitive agents, all patients improved and were discharged from hospital. During follow-ups, one patient died and the remainders were cured. Conclusions:Nocardia infection occurs in lung transplant recipients mostly within 1 year post-operation. There are non-specific symptoms and imaging features of multiple nodules and consolidation. Combination therapy of sensitive agents is indicated for lung transplant recipients with NI.
