Clinical descriptive analysis of severe Pneumocystis jirovecii pneumonia in renal transplantation recipients
| Autor: | Dan Xie, Xiaogang Bi, Heng Li, Ying Xian, Kouxing Zhang, Wen Xu, Mingliang Li, Jingya You, Xiaofeng Yuan |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty 030106 microbiology opportunistic fungal infection Bioengineering macromolecular substances urologic and male genital diseases Applied Microbiology and Biotechnology 03 medical and health sciences 0302 clinical medicine Internal medicine parasitic diseases medicine Pneumocystis jirovecii 030212 general & internal medicine biology business.industry Pneumocystis jirovecii Pneumonia pneumocystis jirovecii pneumonia (pjp) General Medicine metagenomic next-generation sequencing (mngs) renal transplantation biology.organism_classification medicine.disease Transplantation Pneumonia business TP248.13-248.65 trimethoprim-sulfamethoxazole (tmp-smx) Biotechnology |
| Zdroj: | Bioengineered, Vol 12, Iss 1, Pp 1264-1272 (2021) |
| ISSN: | 2165-5987 2165-5979 |
| Popis: | Pneumocystis jirovecii (P. jirovecii) pneumonia (PJP) is an opportunistic fungal infection after renal transplantation, which is always severe, difficult to diagnose, combined with multiple complications and have poor prognosis. We retrospectively analyzed clinical data, including risk factors, diagnosis, treatment and complications of seven clinical cases suffered with severe PJP after renal transplantation in our department in 2019. All the seven recipients were routinely prescribed with PJP prophylaxis after renal transplantation, and six of them suffered acute graft rejection before the infection. P. jirovecii sequence was identified in blood or broncho-alveolar lavage fluid (BALF) by the metagenomic next-generation sequencing (mNGS) in all patients. All the patients were improved with the therapy trimethoprim-sulfamethoxazole (TMP-SMX) combined with caspofungin for the PJP treatment, but suffered with complications including renal insufficiency, leukopenia, thrombocytopenia, gastrointestinal bleeding, mediastinalemphysema, pulmonary hemorrhage, and hemophagocytic syndrome and other severe infections. Taken together, mNGS is a powerful tool that could be used to diagnose PJP in renal transplantation recipients. And PJP prophylaxis should be prescribed during and after treatment for acute rejection. TMP-SMX is the first-line and effective drug for PJP treatment, but the complications are always life-threatening and lead to poor prognosis. We should pay attention to these life-threatening complications. |
| Databáze: | OpenAIRE |
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