title: Cavitary lung lesion 6 years after renal transplantation.
abstract: The differential diagnoses of a cavitary lung lesion in renal transplant recipients would include infection, malignancy and less commonly inflammatory diseases. Bacterial infection, Tuberculosis, Nocardiosis, fungal infections like Aspergillosis and Cryptococcosis need to be considered in these patients. Pulmonary cryptococcosis usually presents 16-21 mo after transplantation, more frequently in patients who have a high level of cumulative immunosuppression. Here we discuss an interesting patient who never received any induction/anti-rejection therapy but developed both BK virus nephropathy as well as severe pulmonary Cryptococcal infection after remaining stable for 6 years after transplantation. This case highlights the risk of serious opportunistic infections even in apparently low immunologic risk transplant recipients many years after transplantation.
authors.affiliation: Arun Kumar Subbiah, Soumita Bagchi, Sanjay Kumar Agarwal, Department of Nephrology, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Arun Kumar
authors.initials: AK
authors.lastname: Subbiah
authors.affiliation: Arun Kumar Subbiah, Soumita Bagchi, Sanjay Kumar Agarwal, Department of Nephrology, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Sudheer
authors.initials: S
authors.lastname: Arava
authors.affiliation: Arun Kumar Subbiah, Soumita Bagchi, Sanjay Kumar Agarwal, Department of Nephrology, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Soumita
authors.initials: S
authors.lastname: Bagchi
authors.affiliation: Arun Kumar Subbiah, Soumita Bagchi, Sanjay Kumar Agarwal, Department of Nephrology, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Karan
authors.initials: K
authors.lastname: Madan
authors.affiliation: Arun Kumar Subbiah, Soumita Bagchi, Sanjay Kumar Agarwal, Department of Nephrology, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Chandan J
authors.initials: CJ
authors.lastname: Das
authors.affiliation: Arun Kumar Subbiah, Soumita Bagchi, Sanjay Kumar Agarwal, Department of Nephrology, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Sanjay Kumar
authors.initials: SK
authors.lastname: Agarwal
keywords: Immunosuppression; Lung cavity; Renal transplantation