移植肾肾周支原体感染  

Perinephric infection in a renal transplant recipient due to mycoplasma

作　　者：毛自 陶冶[1] MAO Zi;TAO Ye(Department of Nephrology,West China Hospital,Sichuan University,Chengdu 6J0041,China)

机构地区：[1]四川大学华西医院肾脏内科,成都610041

出　　处：《肾脏病与透析肾移植杂志》2021年第1期92-96,共5页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：36岁的青年女性,因慢性肾脏病5期于四川大学华西医院行右侧同种异体肾移植术。术后第9天出现发热、移植肾区胀痛。尿培养出粪肠球菌。先后予以哌拉西林舒巴坦、莫西沙星抗感染治疗后尿培养转阴,但患者仍持续发热。术后第17天腹部CT检查提示移植肾周围见包裹性积液,第18天急诊行移植肾清创扩创术清除移植肾周脓肿。送检脓性分泌物4天后结果提示支原体感染,药敏示对米诺环素敏感。予以米诺环素抗感染治疗3周后患者的症状明显缓解,复查腹部CT示脓肿完全消失。患者预后良好,在5个月的随访中未报告有症状复发。支原体在肾移植受者中的定殖率很高,是引起移植肾周感染最主要的病原体,及时的诊断和治疗对肾移植受者非常重要。A 36-year-old female received renal transplantation for chronic kidney disease stage 5 in our hospital.On day 9 post-transplantation, she developed fever and presented with pain at her renal graft site.Enterococcus faecalis was detected in the urine.The urine cultures became negative after she was treated with piperacillin sodium and sulbactam Sodium, moxifloxacin, But the patient still had a fever.An abdominal CT scan indicated a perinephric collection on day 17 and a laparotomy was performed to drain the purulent collection on day 18.Four days later, cultures of intra-operative samples from the perinephric exudate showed mycoplasma, which was susceptible to minocycline.Three weeks after the minocycline therapy, symptoms were significant improved.Repeat imaging revealed complete resolution of the perinephric collection.The patient had a good prognosis and no recurrence of symptoms was reported at a 5-month follow-up appointment.Colonization rate of mycoplasma is high in renal transplant recipients.And mycoplasma is the most important pathogen for perinephric infection in these patients, timely monitor is very important for kidney transplant recipients.

关 键 词：支原体 肾移植受者 肾周感染 

分 类 号：R699.2[医药卫生—泌尿科学]