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成功治疗肾移植患者 COVID-19 后致命性隐孢子虫病:病例报告。

Successful management of life-threatening post-COVID-19 cryptosporidiosis in a renal transplant patient: a case report.

机构信息

Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.

Department of Internal Medicine, Palestinian Medical Complex, Ramallah, Palestine.

出版信息

Pan Afr Med J. 2023 May 4;45:10. doi: 10.11604/pamj.2023.45.10.39548. eCollection 2023.

Abstract

Worldwide, Cryptosporidium spp. is a common parasite that affects domestic and wild animals, including humans, and causes diarrhea in both immunocompetent and immunocompromised hosts. The fecal-oral pathway accounts for the majority of its transfer. Although C. parvum and C. hominis are the most common zoonotic species in humans, other zoonotic species can also infect immunocompetent and immunocompromised people. Patients undergoing renal transplants are more likely to contract cryptosporidiosis, which can cause severe and potentially fatal diarrhea. A 41-year-old male patient who presented to the emergency department complained of a sudden onset, severe and continuous fatigue, and a feverish sensation of two-day duration. Two days prior to the current admission, the patient started to complain of weakness affecting his whole body, as well as a fever of 39°C and continuous yellowish diarrhea occurring 4-5 times daily without blood. Stool analysis revealed a cryptosporidium infection. The patient underwent surgery for kidney transplantation. The donated kidney was the left one from his brother and was attached to the patient´s right groin. As illustrated by our example, cryptosporidiosis should be considered a significant cause of acute, persistent, watery diarrhea in immunocompromised kidney transplant recipients. Patients undergoing renal transplants should be instructed to wash their hands frequently, stay away from young animals, sick people, and swimming pools in order to lower their risk of infection.

摘要

在全球范围内,隐孢子虫是一种常见的寄生虫,可感染包括人类在内的家养和野生动物,并导致免疫功能正常和免疫功能低下的宿主发生腹泻。粪-口途径是其主要传播途径。虽然微小隐孢子虫和人隐孢子虫是人类中最常见的人畜共患种,但其他人畜共患种也可感染免疫功能正常和免疫功能低下的人。接受肾移植的患者更容易感染隐孢子虫病,这可能导致严重且可能致命的腹泻。一名 41 岁的男性患者因突发、严重且持续的疲劳和两天发热就诊于急诊科。在本次入院前两天,患者开始出现全身无力,并伴有 39°C 的发热和持续的黄色腹泻,每天 4-5 次,无血便。粪便分析显示存在隐孢子虫感染。该患者接受了肾移植手术。供肾来自其兄弟的左侧,被移植到患者右侧腹股沟。正如我们的例子所示,隐孢子虫病应被视为免疫功能低下的肾移植受者发生急性、持续性水样腹泻的重要原因。应告知接受肾移植的患者经常洗手,远离幼小动物、病人和游泳池,以降低感染风险。

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