Renal allograft recipient with co-existing BK virus nephropathy and pulmonary histoplasmosis: report of a case

Clin Exp Nephrol. 2010 Dec;14(6):641-4. doi: 10.1007/s10157-010-0332-x. Epub 2010 Aug 17.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Amphotericin B / therapeutic use
  • Histoplasmosis / drug therapy
  • Histoplasmosis / pathology*
  • Humans
  • Kidney Transplantation / pathology
  • Lung Diseases, Fungal / drug therapy
  • Lung Diseases, Fungal / pathology*
  • Male
  • Middle Aged
  • Opportunistic Infections / pathology
  • Polyomavirus Infections / pathology*

Substances

  • Amphotericin B