Yuanyang Shi, Hua Zhang, Yinuo Liu, W. Fang, Ying Xia, Jin Zhao, Gaoling Zhao, Chunquan Sheng, Qingjie Zhao, Yongsheng He, Amanda Juan Chen, Wanqing Liao, Keya Cai, Bo Pan, Weihua Pan
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引用次数: 0
摘要
新生隐球菌可引起有害的隐球菌病和其他严重并发症,尤其是在免疫力低下的人群中。器官移植患者中的播散性隐球菌病极为罕见,通常累及肺、脑、皮肤、指甲和其他器官。本文报告了一例罕见的涉及皮肤和肺部的播散性隐球菌病病例,患者为一名肾移植后免疫力低下的女性,表现为反复发作的深褐色脓肿和结节。血清中隐球菌荚膜多糖的 K-Set 检测结果呈阳性。用 Autof MS 1000 进行的脓培养鉴定表明,患者感染的是新型隐球菌变种 grubii。除了使用两性霉素 B 脂质体、氟胞嘧啶和氟康唑进行治疗外,还在局部抽取脓液,同时向皮损处注射两性霉素 B 脂质体。事实证明,这种综合治疗方法非常有效,患者的发烧和皮肤症状均已痊愈。这种创新的治疗方法可能有助于帮助更多的播散性隐球菌病患者。
Disseminated Cryptococcosis Involving Skin and Lung in an Immunocompromised Patient After Kidney Transplantation: A Case Report
Cryptococcus neoformans can cause detrimental cryptococcosis and other severe complications, especially in immunocompromised populations. Disseminated cryptococcosis in organ transplantation patients is extremely rare and often involves lungs, brains, skin, nails, and other organs. In this paper, we report a rare disseminated cryptococcosis case involving skin and lung that presented with recurrent dark brown abscesses and nodules in an immunocompromised female after kidney transplantation. The K-Set detection result of Cryptococcus capsular polysaccharide in serum is positive. The identification of pus culture by Autof MS 1000 indicates that the patient was infected with Cryptococcus neoformans var. grubii. In addition to treatment using liposomal amphotericin B, fluorocytosine, and fluconazole, local extraction of pus and simultaneous injection of liposomal amphotericin B into skin lesions were performed. This comprehensive treatment method proved effective, as the patient recovered from fever and skin symptoms. The innovative treatment may contribute to helping more disseminated cryptococcosis patients.