Cryptococcal Pneumonia in a Pediatric Patient with Renal Transplantation
Corresponding AuthorSevgin Taner
Ege University Faculty of Medicine, Department of Pediatric Nephrology, Izmir, Turkey
A B S T R A C T
Cryptococcosis is a significant opportunistic infection in solid organ transplant recipients. Patients may have asymptomatic colonization or symptoms of isolated pulmonary disease and severe pneumonia. The disease is diagnosed by culture, direct microscopy or detection of cryptococcal antigen in the body fluid or tissues. We herein present a C. neoformans pneumonia in a renal transplant patient. An 18-year-old male, renal transplanted from his mother, admitted to hospital due to increase in creatinine. On physical examination, there was no finding other than hypertension and operation scar. Urea and creatinine were increased. Renal doppler USG revealed increased renal parenchymal echogenicity. Immunosuppressive drug levels were in normal range. Renal biopsy was consistent with acute cellular rejection and treatment was started. Fever appeared on the following week. Immunosuppressants doses were reduced; antibiotics started empirically. HRCT revealed multiple nodules, lymphadenopathies and pleural effusion. C. neoformans was detected in blood culture. Detailed history revealed the patient was pigeon feeder. Amphotericin B and fluconazole was started. On follow up BPAP was needed owing respiratory distress. Blood culture became negative on the 13th day of treatment. The treatment of the patient was completed in six weeks and followed by prophylaxis. The patient is now being followed up at baseline creatinine 1.73 mg / dl in the 1st year after discharge. We would like to remind that opportunistic fungal infections may also be the cause of fever in solid organ transplant patients. It should be noted these infections may result with high mortality without early diagnosis and appropriate treatment.
Article TypeCase Report
Publication historyReceived: Fri 24, Apr 2020
Accepted: Wed 06, May 2020
Published: Thu 14, May 2020
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