Two Cases of Fatal Hyperammonemia Syndrome due to Mycoplasma hominis and Ureaplasma urealyticum in Immunocompromised Patients Outside Lung Transplant Recipients

Nowbakht, Cima; Edwards, Angelina; Rodriguez-Buritica, David; Luce, Andrea M.; Doshi, Pratik; Golovine, Aleksandra De; Bynon, John S.; Nigo, Masayuki

doi:10.1093/ofid/ofz033

Cited by 39 publications

(49 citation statements)

References 15 publications

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“…12,13 To our knowledge, seven cases of HS in kidney transplant (KT) recipients have been published to date. 9,[14][15][16][17][18][19] Four were attributed to infection, two from Mycobacterium spp., 15,18 one from U parvum, 19 and one from Ureaplasma spp. 11 We present a unique case of HS caused by U. urealyticum infection in a KT recipient.…”

mentioning

confidence: 99%

Hyperammonemia syndrome due to Ureaplasma urealyticum in a kidney transplant recipient: A case of disseminated disease from a fluoroquinolone‐resistant isolate

Higgins¹,

Farmakiotis

Rogers

et al. 2020

Transplant Infectious Dis

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mentioning

confidence: 99%

Hyperammonemia syndrome due to Ureaplasma urealyticum in a kidney transplant recipient: A case of disseminated disease from a fluoroquinolone‐resistant isolate

Higgins¹,

Farmakiotis

Rogers

et al. 2020

Transplant Infectious Dis

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“…These Mollicutes, like all Mycoplasmas , display innate resistance to β-lactams, sulfonamides, trimethoprim, and rifampicin. 59 , 60 M. hominis is uniformly resistant to macrolides, 18 resistance to macrolides, quinolones, lincosamides, and tetracycline have also been observed in Ureaplasma . 60 Dhawan et al has, however, shown that Ureaplasma isolates were susceptible specifically to doxycycline in 91% of cases, josamycin in 86%, ofloxacin in 77%, and azithromycin in 71%, whereas isolates of M. hominis were uniformly susceptible to doxycycline, josamycin, and ofloxacin.…”

Section: Treatmentmentioning

confidence: 99%

“…Systemic Ureaplasma infections have similarly been observed in patients experiencing hyperammonemia following hematopoietic cell transplantation 37 and undergoing immunosuppression for cancer treatment. 18 Furthermore, hyperammonemia has been described in a case report of a lung transplant recipient whose donor lung tested positive for Ureaplasma parvum on bronchioalveolar lavage prior to surgery. 33 A murine model for these transplant patients has shown a causal relationship between systemic infection with Ureaplasma and hyperammonemia in immunosuppressed mice.…”

mentioning

confidence: 99%

Hyperammonemia Post Lung Transplantation: A Review

Leger

Silverman

Hauck

et al. 2020

Clin Med Insights Circ Respir Pulm Med

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Hyperammonemia is the pathological accumulation of ammonia in the blood, which can occur in many different clinical settings. Most commonly in adults, hyperammonemia occurs secondary to hepatic dysfunction; however, it is also known to be associated with other pathologies, surgeries, and medications. Although less common, hyperammonemia has been described as a rare, but consistent complication of solid organ transplantation. Lung transplantation is increasingly recognized as a unique risk factor for the development of this condition, which can pose grave health risks—including long-term neurological sequelae and even death. Recent clinical findings have suggested that patients receiving lung transplantations may experience postoperative hyperammonemia at rates as high as 4.1%. A wide array of etiologies has been attributed to this condition. A growing number of case studies and investigations suggest disseminated opportunistic infection with Ureaplasma or Mycoplasma species may drive this metabolic disturbance in lung transplant recipients. Regardless of the etiology, hyperammonemia presents a severe clinical problem with reported mortality rates as high as 75%. Typical treatment regimens are multimodal and focus on 3 main avenues of management: (1) the reduction of impact on the brain through the use of neuroprotective medications and decreasing cerebral edema, (2) augmentation of mechanisms for the elimination of ammonia from the blood via hemodialysis, and (3) the diminishment of processes producing predominantly using antibiotics. The aim of this review is to detail the pathophysiology of hyperammonemia in the setting of orthotopic lung transplantation and discuss methods of identifying and managing patients with this condition.

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“…Since this series was published, there have been a few additional reports of NCH due to urease-producing organisms in KT recipients. Two recent reports by Nowbakht et al and Legouy et al 7,12 describe fatal cases of NCH due to urease-producing organisms, with both cases treated with levofloxacin and doxycycline.…”

Section: A S E Rep Ortmentioning

confidence: 99%

Successful management of noncirrhotic hyperammonemia syndrome after kidney transplantation from putative Ureaplasma infection

Cheema

Kutzler

Olowofela

et al. 2020

Transplant Infectious Dis

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Two Cases of Fatal Hyperammonemia Syndrome due to Mycoplasma hominis and Ureaplasma urealyticum in Immunocompromised Patients Outside Lung Transplant Recipients

Cited by 39 publications

References 15 publications

Hyperammonemia syndrome due to Ureaplasma urealyticum in a kidney transplant recipient: A case of disseminated disease from a fluoroquinolone‐resistant isolate

Hyperammonemia syndrome due to Ureaplasma urealyticum in a kidney transplant recipient: A case of disseminated disease from a fluoroquinolone‐resistant isolate

Hyperammonemia Post Lung Transplantation: A Review

Successful management of noncirrhotic hyperammonemia syndrome after kidney transplantation from putative Ureaplasma infection

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