肾移植后少见的肺部真菌感染

Report of rare pulmonary funsal infectionafter renal transplantation

真菌感染是器官移植患者的严重并发症之一。若不及时治疗，常导致死亡。本文报告了１０８９／１１４１例次同种异体肾移植术后经尸俭确诊的临床少见的肺部真菌感染８例，分别为曲霉菌感染２例，毛霉菌感染２例，新型隐球菌感染１例，奴卡菌感染３例。其中４例合并细菌感染。对肾移植术后并发肺部真菌感染的发生、临床表现、诊断、治疗及预防进行了详细地讨论。

bjective To report 8 cases of rare pul-monary fungal infections in the recipients ofrenal transplantation and discuss the diag-nosis, management and prevention of pul-monary fungal infectons in this patient pop-ulation.Methods and results Retrospectively anal-ysed the clinical and autopsy data of 27 re-cipients of renal transplantation and discov-ered that 8 patients suffered from pul-monary fungal infections prernortally, in-cluding 1 case of cryptococcosis neofor-mans, 2 cases of niucormycosis, 2 cases ofaspergillosis and 3 cases of Nocardiasis. Bac-terial superinfection was identified in 4 pa-tients. The infections occurred in 15 days to2 years post-transplantation. Premortal clin-ical manifestations included chills, highfever , headache , productive cough and dysp-nea. Diagnoses was established by premortalclinical presentations and autopsy.Conclusions We believe that followingpoints may contribute to early diagnosis andsuccessful management of pulmonary fungalinfections in the recipients of renal trans-plantation : ①lthorough physical examinationbefore transplantation ; ②zclose observationof the clinical manifestations suggestingpossible fungal infection ;③careful examina-tion of the specimens from differentsources ; and ④proper and timely prophylac-tic antifungal treatment.