Endogenous Aspergillus endophthalmitis occurring after kidney transplant

Area of Science:

• Medical Mycology
• Transplantation Immunology
• Infectious Diseases

Background:

• Renal transplantation requires immunosuppression, increasing susceptibility to opportunistic infections.
• Fungal infections, particularly Aspergillus, are serious complications in immunocompromised individuals.
• Cytomegalovirus (CMV) is another common opportunistic pathogen post-transplant.

Purpose of the Study:

• To report two cases of invasive fungal infections in renal transplant recipients.
• To highlight the clinical presentation and outcomes of Aspergillus fumigatus and cytomegalovirus infections.
• To emphasize the challenges in diagnosing and treating these infections in post-transplant settings.

Main Methods:

• Case report 1: Renal transplant recipient with pneumonia and endophthalmitis.
• Case report 2: Renal transplant recipient with disseminated aspergillosis, meningitis, and pneumonia.
• Diagnostic methods included biopsy, vitreous aspiration, smear, culture, and postmortem examination.

Main Results:

• Case 1: Patient developed CMV and Aspergillus pneumonia, followed by Aspergillus endophthalmitis, leading to enucleation despite treatment.
• Case 2: Patient experienced graft rejection, pneumonia, and meningitis, with postmortem findings of disseminated aspergillosis and a choroidal abscess.
• Both patients were on intensive immunosuppressive therapy.

Conclusions:

• Invasive fungal infections, especially Aspergillus, are life-threatening complications in renal transplant patients.
• Early diagnosis and aggressive treatment are crucial but often challenging.
• These cases underscore the importance of vigilant monitoring for opportunistic infections in immunosuppressed populations.