Chronic Candida dubliniensis meningitis in a lung transplant recipient
Chronic Candida dubliniensis meningitis in a lung transplant recipient
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DOI：
10.1016/j.mmcr.2019.03.004
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发表时间：
2019-06-01
影响因子：
2.2
通讯作者：
Rotstein, Coleman
中科院分区：
文献类型：
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作者：
Herrera, Sabina;Pavone, Paolo;Rotstein, Coleman
念珠菌是肺移植受者口腔粘膜和呼吸道的常见定植者。虽然在大多数情况下被认为是非致病性的，但与念珠菌属有关的供体来源的感染。已经描述了在侵袭性念珠菌病的表现中，慢性脑膜炎是最罕见和最具挑战性的诊断之一，这是由于疾病的无痛性和CSF培养的低产量。它与严重的发病率和高死亡率有关。真菌PCR和BD葡聚糖测定可以辅助诊断，尽管这些测试并不广泛使用。我们报告一例可能的供体来源的都柏林念珠菌感染肺移植受体，谁最初提出脓胸，治疗成功，但随后发展为慢性脑膜炎。由于CSF培养物产量低，诊断延迟，并通过真菌PCR和BD葡聚糖测定确认。
Candida spp. are common colonizers of the oral mucosa and respiratory tract in lung transplant recipients. Although thought to be non-pathogenic in most cases, donor derived infections related to Candida spp. have been described. Among the manifestations of invasive candidiasis, chronic meningitis is one of the rarest and one of the most challenging to diagnose, due to the indolence of the disease and the low yield of the CSF cultures. It is associated with severe morbidity and a high mortality. Fungal PCR and BD glucan assays can be assistance in its diagnosis, although these tests are not widely available. We report a case of a possible donor derived Candida dubliniensis infection in a lung transplant recipient, who initially presented with empyema that was treated successfully, but subsequently developed chronic meningitis. Diagnosis was delayed due to the low yield of CSF cultures, and was confirmed with fungal PCR and BD glucan assay.