Renal allograft recipient with co-existing BK virus nephropathy and pulmonary histoplasmosis: report of a case.
Renal allograft recipients are prone to opportunistic infections, rarely multiple coexisting infections, due to the immunocompromised state. To the best of our knowledge, no case of a co-existing polyoma virus nephropathy and pulmonary histoplasmosis in a renal allograft recipient has been reported so far in the available literature. A 55-year-old male renal allograft recipient underwent graft biopsy for asymptomatic graft dysfunction. The graft biopsy showed features of polyoma virus nephropathy. Soon after, he developed fever with pulmonary nodules. Fine-needle aspiration from lung nodules showed intracellular yeast forms of histoplasma. The patient responded well to amphotericin B with subsidence of fever. The co-existence of renal allograft-limited infection like polyoma virus and systemic fungal infection such as histoplasmosis should be kept in mind in a transplant recipient with graft dysfunction and non-specific systemic symptoms. Prompt recognition of these infections permits the clinician to institute appropriate therapeutic modification and improved survival.
Sharma
Alok
A
Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
Gupta
Ruchika
R
Ahuja
Arvind
A
Iyer
Venkateswaran K
VK
Bora
Mitul
M
Agarwal
Sanjay K
SK
Dinda
Amit K
AK
D000666:Amphotericin B / Q000627:therapeutic use; D006660:Histoplasmosis / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D016030:Kidney Transplantation / Q000473:pathology; D008172:Lung Diseases, Fungal / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000473:pathology; D027601:Polyomavirus Infections / Q000473:pathology*
D000666:Amphotericin B