Invasive Pulmonary Aspergillosis and Tuberculosis Complicated by Hemophagocytic Lymphohistiocytosis - Sequelae of COVID-19 in a Liver Transplant Recipient.

侵袭性肺曲霉病和结核并发噬血细胞性淋巴组织细胞增多症 - 肝移植患者 COVID - 19 的后遗症。

• 发表时间: May-Jun 2022
• 来源期刊: J Clin Exp Hepatol
• DOI: 10.1016/j.jceh.2021.12.002
• PMID: 34898957
• 文章类型: Case Reports
• 作者列表: Gandotra A,Mehtani R,Premkumar M,Duseja A,De A,Mallik N,Durgadevi S,Das A,Kalra N

关键词: AFB, Acid-fast bacilli; AKI, Acute kidney Injury; ATT, Antitubercular therapy; BDG, Beta-D Glucan; COVID-19; COVID-19, Coronavirus disease of 2019; DEB-TACE, Drug eluting bead transarterial chemoembolization; GM, Galactomannan; HCC, Hepatocellular Carcinoma; HLH, Hemophagocytic Lymphohistiocytosis; HRCT, High-resolution computed tomography; IDSA, Infectious Diseases Society of America; IPA, Invasive pulmonary aspergillosis; IVIg, Intravenous immunoglobulin; NODAT, New onset diabetes after transplant; PAS, Periodic acid Schiff; RT-PCR, Reverse transcriptase-polymerase chain reaction; SARS-CoV-2, Severe acute respiratory syndrome corona virus 2; disseminated tuberculosis; hemophagocytic lymphohistiocytosis; invasive aspergillosis; liver transplantation; mRECIST, modified response evaluation criteria in solid tumors; sHLH, Secondary hemophagocytic lymphohistiocytosis

Abstract

Liver transplant recipients are at an increased risk of opportunistic infections due to the use of immunosuppression. Coronavirus disease of 2019 (COVID-19) increases the risk of these infections further due to associated immune dysfunction and the use of high-dose steroids. We present a case of a liver transplant recipient who developed disseminated tuberculosis and invasive pulmonary aspergillosis complicated by acquired hemophagocytic lymphohistiocytosis after recovering from severe COVID-19.

摘要

由于使用免疫抑制，肝移植受者机会性感染的风险增加。2019年冠状病毒病（COVID-19）由于相关的免疫功能障碍和高剂量类固醇的使用，进一步增加了这些感染的风险。我们介绍了一例肝移植受者，该受者在从严重的COVID-19中恢复后发展为播散性结核病和侵袭性肺曲霉病并发获得性噬血细胞性淋巴组织细胞增多症。