Hyperammonemia by Ureaplasma urealyticum Pneumonia after Lung Transplantation

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 pa...

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Autores principales: Paparoupa, Maria, Barten, Markus Johannes, de Heer, Jocelyn, Giessen, Hanna Sophie, Frings, Daniel, Kluge, Stefan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218208/
https://www.ncbi.nlm.nih.gov/pubmed/32420020
http://dx.doi.org/10.1016/j.rmcr.2020.101080
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author Paparoupa, Maria
Barten, Markus Johannes
de Heer, Jocelyn
Giessen, Hanna Sophie
Frings, Daniel
Kluge, Stefan
author_facet Paparoupa, Maria
Barten, Markus Johannes
de Heer, Jocelyn
Giessen, Hanna Sophie
Frings, Daniel
Kluge, Stefan
author_sort Paparoupa, Maria
collection PubMed
description 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 * 10(4) 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.
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spelling pubmed-72182082020-05-15 Hyperammonemia by Ureaplasma urealyticum Pneumonia after Lung Transplantation Paparoupa, Maria Barten, Markus Johannes de Heer, Jocelyn Giessen, Hanna Sophie Frings, Daniel Kluge, Stefan Respir Med Case Rep Case Report 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 * 10(4) 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. Elsevier 2020-05-06 /pmc/articles/PMC7218208/ /pubmed/32420020 http://dx.doi.org/10.1016/j.rmcr.2020.101080 Text en © 2020 The Authors. Published by Elsevier Ltd. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Paparoupa, Maria
Barten, Markus Johannes
de Heer, Jocelyn
Giessen, Hanna Sophie
Frings, Daniel
Kluge, Stefan
Hyperammonemia by Ureaplasma urealyticum Pneumonia after Lung Transplantation
title Hyperammonemia by Ureaplasma urealyticum Pneumonia after Lung Transplantation
title_full Hyperammonemia by Ureaplasma urealyticum Pneumonia after Lung Transplantation
title_fullStr Hyperammonemia by Ureaplasma urealyticum Pneumonia after Lung Transplantation
title_full_unstemmed Hyperammonemia by Ureaplasma urealyticum Pneumonia after Lung Transplantation
title_short Hyperammonemia by Ureaplasma urealyticum Pneumonia after Lung Transplantation
title_sort hyperammonemia by ureaplasma urealyticum pneumonia after lung transplantation
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218208/
https://www.ncbi.nlm.nih.gov/pubmed/32420020
http://dx.doi.org/10.1016/j.rmcr.2020.101080
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