Hyperammonemia by Ureaplasma urealyticum Pneumonia after Lung Transplantation
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Hyperammonemia by Ureaplasma urealyticum Pneumonia after Lung Transplantation. / Paparoupa, Maria; Barten, Markus Johannes; de Heer, Jocelyn; Giessen, Hanna Sophie; Frings, Daniel; Kluge, Stefan.
in: RESPIR MED CASE REP, Jahrgang 30, 101080, 2020.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Hyperammonemia by Ureaplasma urealyticum Pneumonia after Lung Transplantation
AU - Paparoupa, Maria
AU - Barten, Markus Johannes
AU - de Heer, Jocelyn
AU - Giessen, Hanna Sophie
AU - Frings, Daniel
AU - Kluge, Stefan
PY - 2020
Y1 - 2020
N2 - Ureaplasma urealyticum is a commensal of the female genital tract and can be detected as a pathogen in urethritis and vaginitis. Its importance as a respiratory pathogen beyond the field of neonatology remains controversial. We report a case of Ureaplasma-pneumonia in a recently lung-transplanted patient, with hyperammonemic syndrome. The 51-year-old lung-transplanted female was admitted to the intensive care unit with new-onset reduction of her mental state due to hyperammonemia. A diagnostic bronchoscopy showed purulent bronchitis and multiple superficial ulcerations of the bronchial mucosa. The DNA-PCR from bronchoalveolar lavage confirmed the presence of Ureaplasma urealyticum in low concentration (about 5 * 104 copies/ml), which was interpreted as evidence of infection and treated with Doxycycline intravenously. Ureaplasma was also identified by DNA-PCR in the biopsy specimens of the inflammatory enlarged mediastinal lymph nodes. Bilateral pleural effusions were found to be transudative and culturally sterile. Ureaplasma-pneumonia can cause fatal hyperammonemia in lung-transplant patients and should be considered in the differential diagnosis of every unclear hyperammonemia with normal liver function. The early identification and treatment of the infection leads to clinical and biochemical resolution.
AB - Ureaplasma urealyticum is a commensal of the female genital tract and can be detected as a pathogen in urethritis and vaginitis. Its importance as a respiratory pathogen beyond the field of neonatology remains controversial. We report a case of Ureaplasma-pneumonia in a recently lung-transplanted patient, with hyperammonemic syndrome. The 51-year-old lung-transplanted female was admitted to the intensive care unit with new-onset reduction of her mental state due to hyperammonemia. A diagnostic bronchoscopy showed purulent bronchitis and multiple superficial ulcerations of the bronchial mucosa. The DNA-PCR from bronchoalveolar lavage confirmed the presence of Ureaplasma urealyticum in low concentration (about 5 * 104 copies/ml), which was interpreted as evidence of infection and treated with Doxycycline intravenously. Ureaplasma was also identified by DNA-PCR in the biopsy specimens of the inflammatory enlarged mediastinal lymph nodes. Bilateral pleural effusions were found to be transudative and culturally sterile. Ureaplasma-pneumonia can cause fatal hyperammonemia in lung-transplant patients and should be considered in the differential diagnosis of every unclear hyperammonemia with normal liver function. The early identification and treatment of the infection leads to clinical and biochemical resolution.
U2 - 10.1016/j.rmcr.2020.101080
DO - 10.1016/j.rmcr.2020.101080
M3 - SCORING: Journal article
C2 - 32420020
VL - 30
JO - RESPIR MED CASE REP
JF - RESPIR MED CASE REP
SN - 2213-0071
M1 - 101080
ER -
