一例新冠肺炎所致肺纤维化患者双隆移植术后近平滑念珠菌感染。

IF 2.5 4区 医学 Q2 PATHOLOGY Cytojournal Pub Date : 2023-02-02 eCollection Date: 2023-01-01 DOI:10.25259/Cytojournal_67_2020
Hong-Rui Chen, Mei Xue, Hao Zhou, Yao-Gong Wu, Yan Chen, Wan-Xin Chen
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引用次数: 0

摘要

肺纤维化是2019冠状病毒病(新冠肺炎)患者的并发症。广泛性肺纤维化是对患者生命的严重威胁,肺移植是延长患者生命的最后手段。我们报告了一例危重型新冠肺炎患者,尽管使用了多种治疗措施,包括抗病毒、抗感染、提高免疫力、恢复期血浆、俯卧位通气和光纤支气管镜气道清洁,尽管他的新冠肺炎核酸检测呈阴性,但患者仍发展为不可逆的广泛性肺纤维化,呼吸力学提示肺顺应性不能有效恢复。在呼吸机和体外膜肺氧合的辅助下73天,他终于接受了双肺移植。术后第2天,对移植肺肺泡灌洗液进行细胞形态学检查,肺泡上皮细胞形态完整、正常。术后第20天,胸部X线片显示右肺中部有一个巨大的致密阴影。第21天,患者接受纤维支气管镜检查,右侧支气管刷涂细胞学检查发现酵母样真菌孢子,经真菌培养证实为拟裸念珠菌感染。由于我们医院的精心治疗和护理,他恢复得很好。直到7月29日,也就是移植后96天,患者才康复出院。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Candida parapsilosis infection after double-lung transplantation in a patient with pulmonary fibrosis caused by COVID-19.

Pulmonary fibrosis is a complication in patients with coronavirus disease 2019 (COVID-19). Extensive pulmonary fibrosis is a severe threat to patients' life and lung transplantation is last resort to prolong the life of patients. We reported a case of critical type COVID-19 patient, though various treatment measures were used, including anti-virus, anti-infection, improving immunity, convalescent plasma, prone position ventilation, and airway cleaning by fiber-optic bronchoscope, although his COVID-19 nucleic acid test turned negative, the patient still developed irreversible extensive pulmonary fibrosis, and respiratory mechanics suggested that lung compliance could not be effectively recovered. After being assisted by ventilator and extracorporeal membrane oxygenation for 73 days, he finally underwent double-lung transplantation. On the 2nd day after the operation, the alveolar lavage fluid of transplanted lung was examined by cytomorphology, and the morphology of alveolar epithelial cells was intact and normal. On the 20th day post-transplantation, the chest radiograph showed a large dense shadow in the middle of the right lung. On the 21st day, the patient underwent fiber-optic bronchoscopy, yeast-like fungal spores were found by cytomorphological examination from a brush smear of the right bronchus, which was confirmed as Candida parapsilosis infection by fungal culture. He recovered well due to the careful treatment and nursing in our hospital. Until July 29, 96 days after transplantation, the patient was recovery and discharged from hospital.

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来源期刊
Cytojournal
Cytojournal PATHOLOGY-
CiteScore
2.20
自引率
42.10%
发文量
56
审稿时长
>12 weeks
期刊介绍: The CytoJournal is an open-access peer-reviewed journal committed to publishing high-quality articles in the field of Diagnostic Cytopathology including Molecular aspects. The journal is owned by the Cytopathology Foundation and published by the Scientific Scholar.
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