A case of Chlamydia trachomatis infection in a renal allograft patient

We describe a renal allograft patient with a Chlamydia trachomatis infection. A 43 year-old man was diagnosed with end-stage renal disease in 1985 which necessitated the transplantation of a cadaver kidney in 1986. The kidney was rejected two years later. A second transplantation was performed in 1991. At the beginning of 1998 symptoms and signs of chronic renal failure and dysuria set in. Routine microbiological studies were negative. Cell culture on McCoy cell line was positive for an active infection with C. trachomatis--initially 3+, then 2+, 1+ and negative following treatment. The patient was positive on the AMPLICOR CT/NG test (Roche Diagnostic Systems, Branchburg, USA) twice with OD values OVER--above 2 at 450 nm wavelength measured on an ELISA reader. The patient received treatment with azithromycin and doxycycline for 10 days following which the serum creatinine levels fell and the creatinine clearance values improved. Dynamic microbiological follow-up showed disappearance of C. trachomatis as evidenced by the negative PCR test. We conclude that the deterioration of renal function in our patient is complex but the infection with C. trachomatis is part of the complex of the underlying chronic renal failure and immunosuppressive treatment.