A case of late-onset organizing pneumonia following COVID-19 infection in a post-kidney transplant patient.

IF 1 Q4 UROLOGY & NEPHROLOGY
CEN Case Reports Pub Date : 2024-10-01 Epub Date: 2024-02-17 DOI:10.1007/s13730-023-00849-9
Kumiko Fujieda, Shoji Saito, Akihito Tanaka, Kazuhiro Furuhashi, Yosinari Yasuda, Yuta Sano, Masashi Kato, Shoichi Maruyama
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Abstract

A 50-year-old man who had undergone a living-donor kidney transplant 12 years prior for chronic renal failure due to autosomal dominant polycystic kidney disease contracted coronavirus disease 19 (COVID-19). He had a positive antigen test, mild symptoms, sore throat, and fever of 37.9 ℃. The patient was treated with molnupiravir for 5 days, and the symptoms disappeared 5 days after onset. However, 10 days after onset, he developed a fever of approximately 37 ℃ and a non-productive cough; 27 days after onset, the patient was hospitalized for anorexia and a worsening respiratory condition. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigen test results on admission were negative, and no antiviral medications were administered against SARS-CoV-2. Computed tomography revealed extensive ground-glass opacities in both lung fields. The patient was treated with steroid pulse therapy, ceftriaxone, atovaquone, azithromycin, and respiratory management using a high-flow nasal cannula. The combined therapies were successful, and the patient was managed with a nasal oxygen cannula after 3 days. Oxygen administration was discontinued after 6 days of hospitalization, and the patient was discharged after 14 days. Based on the laboratory findings, bacterial, interstitial, and Pneumocystis pneumonia were unlikely. The success of the steroid pulse therapy suggested that respiratory failure was caused by pneumonia due to the immune response after COVID-19 infection.

一例肾移植术后患者感染 COVID-19 后引发的迟发性组织化肺炎。
一名因常染色体显性多囊肾病导致慢性肾衰竭而在 12 年前接受过活体供肾移植手术的 50 岁男子感染了冠状病毒病 19(COVID-19)。他的抗原检测呈阳性,症状轻微,咽喉疼痛,发烧 37.9 ℃。患者接受了 5 天的莫仑吡韦治疗,发病 5 天后症状消失。然而,发病 10 天后,他又出现了约 37 ℃ 的发烧和无痰咳嗽;发病 27 天后,患者因厌食和呼吸道状况恶化而住院治疗。入院时的严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)抗原检测结果为阴性,也没有服用抗 SARS-CoV-2 的药物。计算机断层扫描显示,患者双肺广泛出现磨玻璃不透光。患者接受了类固醇脉冲疗法、头孢曲松、阿托伐醌、阿奇霉素治疗,并使用高流量鼻插管进行呼吸管理。综合疗法取得了成功,3 天后患者接受了鼻氧插管治疗。住院 6 天后停止供氧,14 天后患者出院。根据实验室检查结果,细菌性肺炎、间质性肺炎和肺孢子菌肺炎的可能性不大。类固醇脉冲疗法的成功表明,呼吸衰竭是由 COVID-19 感染后的免疫反应导致的肺炎引起的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CEN Case Reports
CEN Case Reports UROLOGY & NEPHROLOGY-
CiteScore
1.90
自引率
0.00%
发文量
80
期刊介绍: Clinical and Experimental Nephrology (CEN) Case Reports is a peer-reviewed online-only journal, officially published biannually by the Japanese Society of Nephrology (JSN).  The journal publishes original case reports in nephrology and related areas.  The purpose of CEN Case Reports is to provide clinicians and researchers with a forum in which to disseminate their personal experience to a wide readership and to review interesting cases encountered by colleagues all over the world, from whom contributions are welcomed.
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