■在肾移植受者的感染中,脑脓肿是一种罕见的危及生命的并发症.尽管在诊断和治疗方面有所改进,死亡率仍然很高。
■我们进行了一项观察性研究,描述发病率,介绍,牵涉病原体,我们中心肾移植后脑脓肿的治疗和结局。
■在1991年6月至2023年1月期间在我们中心接受肾脏移植的1492例患者中(累计随访:4936例患者年),五女四男,发达的脑脓肿。发病率(风险)为0.6%,发病率为6.03例/1000患者年。从移植到脑脓肿发展的中位持续时间为5周(范围:4周至9年)。最常见的演讲是头痛。9名患者中有8名建立了明确的微生物学诊断。最常见的有牵连的生物是一种脱脂性真菌,紫罗兰(3名患者,33.3%)。尽管免疫抑制减少,手术后送和最佳药物治疗,五名(55.55%)病人死于疾病。
■肾移植后脑脓肿并不常见,危及生命的状况.它通常发生在移植后的早期,并且表现通常是微妙的。与有免疫能力的人不同,真菌是那些有实体器官移植的人中最常见的致病生物。管理包括减少免疫抑制,早期抗菌治疗,和手术减压。
UNASSIGNED: Amongst the infections in kidney transplant recipients, brain abscess represents an uncommon life-threatening complication. Mortality continues to be high despite improvements in diagnostics and therapeutics.
UNASSIGNED: We conducted an observational
study, describing the incidence, presentation, implicating pathogen, management and outcome of brain abscess following kidney transplantation at our centre.
UNASSIGNED: Amongst the 1492 patients who underwent kidney transplantation at our centre between June 1991 and January 2023 (cumulative follow-up: 4936 patient-years), five females and four males, developed brain abscesses. The incidence proportion (risk) is 0.6% with an incidence rate of 6.03 cases per 1000 patient years. The median duration from transplant to development of brain abscess was 5 weeks (range: 4 weeks to 9 years). The commonest presentation was a headache. A definitive microbiological diagnosis was established in eight out of nine patients. The commonest implicated organism was a dematiaceous fungus, Cladophialophora bantiana (3 patients, 33.3%). Despite the reduction in immunosuppression, surgical evacuation and optimal medical therapy, five (55.55%) patients succumbed to their illness.
UNASSIGNED: Brain abscesses following kidney transplantation is an uncommon, life-threatening condition. It usually occurs in the early post-transplant period and the presentation is often subtle. Unlike immunocompetent individuals, a fungus is the most common causative organism in those with solid organ transplants. The management includes a reduction in immunosuppression, early antimicrobial therapy, and surgical decompression.