肾移植术后结核分枝杆菌并软组织马尔尼菲蓝状菌感染1例  

Mycobacterium tuberculosis associated with soft tissue Talaromyces marniffei infection after kidney transplantation:one case report

作　　者：杨锦然 李新长[1] 何小平 刘刚 方泽鸿 Yang Jinran;Li Xinchang;He Xiaoping;Liu Gang;Fang Zehong(Department of Organ Transplantation,Jiangxi Provincial People's Hospital(First Affiliated Hospital,Nanchang Medical College),Nanchang 330000,China)

机构地区：[1]江西省人民医院(南昌医学院第一附属医院)器官移植科,南昌330000

出　　处：《中华器官移植杂志》2024年第12期903-906,共4页Chinese Journal of Organ Transplantation

摘　　要：回顾1例肾移植术后受者同时感染结核分枝杆菌及马尔尼菲蓝状菌(Talaromyces marniffei,TM)的诊疗经过。该例治疗前期被误诊为结核分枝杆菌单一感染,后经抗结核治疗效果差和病情继续进展,及时完善相关病原学检查,最终确诊皮肤软组织TM感染。先后给予两性霉素B胆固醇硫酸脂复合物、伏立康唑、伊曲康唑治疗,同时降低免疫抑制剂强度,软组织TM感染病情治愈,治疗期间移植肾功能正常。随访1年余,未见病情反复。It described the diagnosis and treatment of a kidney transplant recipient simultaneously infected with Mycobacterium tuberculosis and Talaromyces marniffei(TM).In early stage of treatment,this case was misdiagnosed as a single infection of Mycobacterium tuberculosis tuberculosis.However,anti-tuberculosis treatment was ineffective and general condition continued to deteriorate.Pathogenic examination yielded a definite diagnosis of skin and soft tissue infection caused by TM.The patient was cured with amphotericin B cholesterol sulfate complex,voriconazole and itraconazole successively while tapering the intensity of immunosuppressants.Transplanted kidney function normalized.There was no recurrence during a follow-up period of over 1 year.

关 键 词：肾移植 结核分枝杆菌 马尔尼菲蓝状菌 感染 

分 类 号：R699.2[医药卫生—泌尿科学]