Abstract
Introduction Penicillium Marneffei (PM) infections often present with nonspecific clinical manifestations, and severe respiratory failure after infection is particularly uncommon. This case report elucidates the nursing care provided to a patient who developed severe respiratory failure due to PM infection post-kidney transplantation. Additionally, it delves into pertinent intervention measures and nursing strategies.
Clinical Findings A 35-year-old male, more than a decade post-kidney transplantation, was admitted to the nephrology department for "chest tightness and a two-day reduction in urine output." He exhibited dyspnea, decreased blood pressure, and a resting SpO2 of 90% while on mask oxygen inhalation, necessitating his transfer to the ICU.
Diagnosis The patient was diagnosed with PM infection, respiratory failure, and post-kidney transplant status.
Interventions In the ICU, interventions included the application and evaluation of nitric oxide combined with ECMO-prone position ventilation to alleviate hypoxia, dynamic adjustment and vigilant monitoring of the antimicrobial Voriconazole, balancing bleeding and thrombosis risks, proactive anemia correction, early enteral nutrition guided by intra-abdominal pressure and ultrasound assessment, and adaptive progression to pulmonary rehabilitation exercises.
Outcomes By the eighth day in the ICU, the patient's oxygenation had markedly improved, allowing a reduction in ECMO support and subsequent removal. The tracheal tube was extracted on the tenth day, and high-flow oxygen was administered. The patient was transferred to a general ward on the twelfth day.
Conclusion Acute respiratory failure following PM infection in solid organ transplant recipients is exceedingly rare, and nurses may lack pertinent care experience. This case is a valuable reference for critical care nurses managing patients in similar conditions.