Cryptococcal pyelonephritis and disseminated cryptococcosis in a renal transplant recipient.
Symptomatic cryptococcal pyelonephritis, meningitis, and disseminated cryptococcosis are described in a renal cadaver transplant recipient who subsequently died of Klebsiella pneumoniae sepsis. The presence of cryptococcuria and a subsequent positive CSF India ink stain led to the initial diagnosis of disseminated cryptococcosis. Therapy with 0.511 g of amphotericin B and 112.5 g of flucytosine for four weeks did not eradicate Cryptococcus from the kidney and was associated with hepatotoxicity. The importance of urinary examination and culture for C neoformans is emphasized. Cryptococcal pyelonephritis should be considered in the differential diagnosis of allograft rejection in the renal transplant patient.
D002102:Cadaver; D003453:Cryptococcosis; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D007710:Klebsiella Infections; D008581:Meningitis / Q000209:etiology; D008875:Middle Aged; D011704:Pyelonephritis / Q000209:etiology*; D014184:Transplantation, Homologous; D014552:Urinary Tract Infections