肾移植术后,反复发热、腹泻、腹膜后淋巴结肿大
发布时间：2018-11-18 18:52
【摘要】：中年男性,肾移植术后服用泼尼松、环孢素、硫唑嘌呤及雷公藤多苷片等抗排斥治疗,既往曾患新生隐球菌病(累及肺部及中枢神经系统),氟康唑及伊曲康唑抗真菌治疗后痊愈,后续泼尼松联合吗替麦考酚酯、他克莫司抗排斥。近4月出现反复发热伴腹泻,PET-CT提示全身多处淋巴结代谢增高,多次痰及尿液找抗酸杆菌阳性,腹腔淋巴结活检提示"鸟型胞内分支杆菌假瘤",最终诊断为播散性鸟胞内分枝杆菌复合体感染,经治疗后病情稳定。
[Abstract]:A middle-aged man who received anti-rejection therapy such as prednisone, cyclosporine, azathioprine and tripterygium wilfordii polyglycosides after kidney transplantation, had a history of cryptococcosis (involving the lungs and central nervous system). Fluconazole and itraconazole were cured after antifungal therapy, followed by prednisone combined with motimicol ester, tacrolimus anti-rejection. In the last four months, repeated fever and diarrhea appeared. PET-CT indicated that the metabolism of multiple lymph nodes was increased, acid-fast bacilli were positive in sputum and urine many times, and abdominal lymph node biopsy suggested that "pseudotumor of Mycobacterium endocytogenes in birds". Finally, disseminated mycobacterium complex infection was diagnosed, and the disease was stable after treatment.
【作者单位】： 南京军区南京总医院肾脏科国家肾脏疾病临床医学研究中心全军肾脏病研究所;
【分类号】：R699.2
本文编号：2340866
[Abstract]:A middle-aged man who received anti-rejection therapy such as prednisone, cyclosporine, azathioprine and tripterygium wilfordii polyglycosides after kidney transplantation, had a history of cryptococcosis (involving the lungs and central nervous system). Fluconazole and itraconazole were cured after antifungal therapy, followed by prednisone combined with motimicol ester, tacrolimus anti-rejection. In the last four months, repeated fever and diarrhea appeared. PET-CT indicated that the metabolism of multiple lymph nodes was increased, acid-fast bacilli were positive in sputum and urine many times, and abdominal lymph node biopsy suggested that "pseudotumor of Mycobacterium endocytogenes in birds". Finally, disseminated mycobacterium complex infection was diagnosed, and the disease was stable after treatment.
【作者单位】： 南京军区南京总医院肾脏科国家肾脏疾病临床医学研究中心全军肾脏病研究所;
【分类号】：R699.2
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1 唐雄;高兴林;;以肺部肿块为表现的鸟胞内分支杆菌肺病1例[J];实用医学杂志;2005年21期
，本文编号：2340866
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