Early diagnosis and management of acute respiratory distress syndrome caused by fungal pneumonia after renal transplantation

Objective:To study the early diagnosis and management of the patients with acute respiratory distress syndrome (ARDS) caused by fungal pneumonia after renal transplantation.Methods:The clinical data of 6 patients with ARDS caused by fungal pneumonia after renal transplantation in our hospital from January 2002 to October 2005 was retrospectively analyzed. All cases were reduced or stopped dosage of immunosuppressants, treated with intervenous drop infusion of Diflucan、Itraconazole et al. The patients were subjected to non-invasive breathing machine assist ventilation and nutrition supply.Results:Totally 6 patients relieved in 11 to 27 days and recovered in one months.Conclusions:Adjustment of immunosuppressive agents dosage, decisive administration with anti-fungal drugs, early management with non-invasive breathing machine assist ventilation, much dosage glucocorticoid used and effective nutrition supply are important for the treatment of patients with ARDS caused by fungal pneumonia after renal transplantation. The key of early diagnosis lies in combining chest X-ray or sputum culture or bronchoalceolar lavage (BAL) with clinical presentation.