Abstract: SA-PO1017
Successful Resolution of Fungal Pyelonephritis in a Kidney Transplant Recipient
Session Information
- Transplantation: Clinical - 4
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Suarez, Gina G., Jackson Memorial Hospital, Miami, Florida, United States
- Marrero Lozada, Gretchen N., University of Miami Miller School of Medicine, Miami, Florida, United States
- Alonso, Shawn, University of Miami Miller School of Medicine, Miami, Florida, United States
- Ladino Avellaneda, Marco A., University of Miami Miller School of Medicine, Miami, Florida, United States
Introduction
Fungal pyelonephritis in the context of a kidney transplant refers to a renal infection caused by fungi, which can complicate the post-transplant course and potentially lead to delayed graft function. This condition is relatively rare but can be severe, leading to serious consequences such as graft loss and even death if not promptly identified and treated.
Various fungi can cause pyelonephritis in kidney transplant recipients. Candida glabrata has been reported to cause emphysematous pyelonephritis, a serious necrotizing infection. Surgical interventions such as graft nephrectomy may be required in severe cases. However, the specific treatment approach, including the choice of antifungal agent and the duration of therapy, should be individualized based on the patient's clinical condition, the causative organism, and the presence of any complications.
Case Description
A 52-year-old male with a history of IgA Nephropathy and a deceased donor kidney transplant presented two months post-transplant with fevers alongside stage II acute kidney injury. Despite isotonic intravenous fluids, his renal function did not improve, necessitating a kidney biopsy to elucidate the underlying cause of his deteriorating condition. He was diagnosed with fungal pyelonephritis from Candida glabrata, and was ultimately treated with fluconazole. The patient did not lose the allograft and has maintained stable renal function with lifelong antifungal therapy.
Discussion
This case represents the first documented instance within the scientific literature of a successful therapeutic resolution of fungal pyelonephritis attributable to Candida glabrata in a kidney transplant recipient. The treatment efficacy delineated in this scenario is particularly noteworthy given the complexity often associated with opportunistic fungal infections in immunocompromised hosts.
The Grocott's Methenamine Silver (GMS) stain revealed the presence of an abundant number of yeast cells.