ABSTRACT
In rheumatic diseases the possibility of pulmonary manifestation must always be considered and checked. Interstitial lung disease can often be fatal in these cases. In the presented case, the link between progressive dyspnea and newly occurring skin irritation is to be seen as particularly important. A good outcome can be achieved by immediate therapy with immunosuppression and plasmapheresis.
Subject(s)
Dyspnea , Lung Diseases, Interstitial , Humans , Dyspnea/diagnosis , Dyspnea/etiology , Dyspnea/therapy , Lung , Lung Diseases, Interstitial/diagnosis , Lung Diseases, Interstitial/therapyABSTRACT
If a malignant disease is suspected, rapid diagnosis of suspicious pulmonary masses is required. In the presented case, malignancy was repeatedly not proven. Only the test-appropriate antibiotic treatment of an intestinal germ that was initially assessed as an impurity brought the therapeutic success with total remission. In our case the treatment with broad-spectrum penicillin piperacillin/tazobactam was ineffective and only the gyrase inhibitors ciprofloxacin and levofloxacin brought therapeutic success.
Subject(s)
Hafnia alvei , Lung Neoplasms , Anti-Bacterial Agents/therapeutic use , Humans , Lung Neoplasms/complications , Lung Neoplasms/diagnosisABSTRACT
INTRODUCTION: Chronic kidney disease (CKD) is associated with significant morbidity and mortality after lung transplantation (LTX). Calcineurin inhibitor (CNI) nephrotoxicity is the leading cause of CKD. After kidney transplantation, polyomavirus-associated nephropathy (PyVAN) is a well-recognized problem. This study aims to evaluate the role of polyomavirus in patients after LTX. METHODS: From January 2017 to January 2020, all lung transplant recipients who performed follow-up visits in our center were included in the study and retrospectively assessed. We measured renal function (creatinine levels before and after transplantation), JCPyV, and BKPyV load by polymerase chain reaction (PCR) in serum and urine samples after transplantation. RESULTS: In total, 104 consecutive patients (59 males, 56.7%) with a mean age of 49.6 ± 11.1 years were identified. JCPyV was found in urine of 36 patients (34.6%) and serum of 3 patients (2.9%). BKPyV was found in urine of 40 patients (38.5%) and serum of 4 patients (3.8%), respectively. Urine evidence for JCPyV (p < 0.001, coefficient: +21.44) and BKPyV (p < 0.001, coefficient: +29.65) correlated highly with further kidney function decline. CONCLUSION: Kidney function deterioration is associated with JCPyV and BKPyV viruria in patients after LTX. This might indicate a role of PyVAN in lung transplant recipients.