title: Disseminated cryptococcal infection in allogeneic stem cell transplant patients: a rare cause of acute kidney injury.
abstract: Hematopoietic stem cell transplantation (HSCT) can be lifesaving for some of the deadliest hematologic diseases. However, immunosuppression, polypharmacy and risk of infectious complications associated with HSCT can increase morbidity and mortality for recipients. Incidence of acute kidney injury (AKI) after HSCT can be as high as 70%, and concomitant infection can be a therapeutic challenge for oncologists, nephrologists and infectious disease specialists. We illustrate this challenge in the case of a 31-year-old man with acute lymphoblastic leukemia who underwent a double cord HSCT complicated by GvHD, systemic cryptococcal and BK virus infections and AKI. Kidney biopsy showed round to cup-shaped organisms with occasional budding, consistent with Cryptococcus and thrombotic microangiopathy. We discuss our findings and a literature review of disseminated cryptococcal infection with renal involvement after HSCT.
authors.affiliation: Department of Infectious Diseases, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: N
authors.initials: N
authors.lastname: Oliver
authors.affiliation: Division of Renal Diseases and Hypertension, The University of Texas Medical School at Houston, Houston, TX, USA.
authors.forename: T
authors.initials: T
authors.lastname: Luong
authors.affiliation: Department of Pathology and Laboratory Medicine, The University of Texas Medical School at Houston, Houston, TX, USA.
authors.forename: A
authors.initials: A
authors.lastname: Tchakarov
authors.affiliation: Division of Medical Oncology, Duke University Medical Center, Durham, NC, USA.
authors.forename: M
authors.initials: M
authors.lastname: Abdelrahim
authors.affiliation: Department of Infectious Diseases, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: V E
authors.initials: VE
authors.lastname: Mulanovich
authors.affiliation: Department of Infectious Diseases, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: D P
authors.initials: DP
authors.lastname: Kontoyiannis
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: R
authors.initials: R
authors.lastname: Jones
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: P
authors.initials: P
authors.lastname: Kebriaei
authors.affiliation: Division of Renal Diseases and Hypertension, The University of Texas Medical School at Houston, Houston, TX, USA.
authors.forename: J
authors.initials: J
authors.lastname: Samuels
authors.affiliation: Department of Pathology and Laboratory Medicine, The University of Texas Medical School at Houston, Houston, TX, USA.
authors.forename: W
authors.initials: W
authors.lastname: Glass
authors.affiliation: Division of Internal Medicine, Section of Nephrology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: A
authors.initials: A
authors.lastname: Abudayyeh
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000382:microbiology; D000328:Adult; D003453:Cryptococcosis / Q000635:transmission*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D057049:Thrombotic Microangiopathies / Q000209:etiology; D014184:Transplantation, Homologous