title: Fungal infection presenting as giant cell tubulointerstitial nephritis in kidney allograft.
abstract: Giant cell tubulointerstitial nephritis in the kidney allograft caused by infection is rare, and donor-transmitted infection in transplanted kidneys is also rare. In this case report, we describe an unusual histological manifestation of Candida albicans in the graft biopsy of a 53-year-old male kidney transplant recipient with decreased renal function 12 days post transplant. Several giant cells were present in the tubulointerstitial inflammation, as well as yeasts, with no evidence of rejection, and the histological diagnosis was confirmed by urine culture. Donor urine culture was positive for C. albicans, suggestive of a possible donor-transmitted infection. Prompt antifungal treatment eradicated the infection, and averted systemic spread. To our knowledge, there are no previous reports of Candida infection with giant cell tubulointerstitial nephritis in human renal allograft.
authors.affiliation: Department of Pathology, The Johns Hopkins School of Medicine, Baltimore, Maryland 21205, USA. sbagnas1@jhmi.edu
authors.forename: S M
authors.initials: SM
authors.lastname: Bagnasco
authors.forename: A K
authors.initials: AK
authors.lastname: Subramanian
authors.forename: N M
authors.initials: NM
authors.lastname: Desai
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D002176:Candida albicans / Q000302:isolation & purification; D002177:Candidiasis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000188:drug therapy / Q000382:microbiology*; D014019:Tissue Donors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014556:Urine / Q000382:microbiology
chemical_list: D000935:Antifungal Agents