COCCIDIOIDOMYCOSIS AND RENAL TRANSPLANTATION
COCCIDIOIDOMYCOSIS AND RENAL TRANSPLANTATION
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球孢子菌病和肾移植
DOI：
10.1097/00007890-197706000-00005
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发表时间：
1977
期刊：
影响因子：
6.2
通讯作者：
R. Weil
中科院分区：
文献类型：
--
作者：
G. P. Schröter;K. Bakshandeh;B. Husberg;R. Weil
总结两例球孢子菌病检测一组超过750肾移植。第一例患者在初次移植后41/2年和再次移植后6天死于意外播散性球孢子菌病。在第二例患者中，肺球孢子菌病在移植前被确认并通过肺叶切除术和阿替霉素B治疗;随后的移植提供了良好的肾功能，5年来没有复发感染。其他6例球孢子菌病报告的经验表明，在免疫抑制移植受者中，既存球孢子菌感染加重和传播的风险很高。尽管如此，如果在开始免疫抑制前积极治疗活动性球孢子菌病，并且仔细监测移植后感染加重的可能性，则这种风险是可以接受的。
SUMMARY Two cases of coccidioidomycosis detected in a group of more than 750 renal transplants are presented. The first patient died from unsuspected disseminated coccidioidomycosis 41/2 years after primary transplantation and 6 days after retransplantation. In the second patient pulmonary coccidioidomycosis was recognized and treated by lobectomy and amphotericin B before transplantation; subsequent transplantation has provided good renal function without recurrence of infection for 5 years. Experience with six other reported cases of coccidioidomycosis illustrates the high risk of exacerbation and dissemination of preexisting coccidioidal infection in immuno-suppressed transplant recipients. Nevertheless, this risk can be made acceptable if active coccidioidomycosis is treated vigorously before immunosuppression is started and if the possibility of exacerbation of infection after transplantation is carefully monitored.