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Renal transplant artery rupture secondary to candida infection

G Pluemecke1, J Williams, D Elliott

  • 1Department of Internal Medicine, Foothills Hospital, Calgary, Canada.

Nephron
|January 1, 1992
PubMed

Insights

A diabetic renal transplant patient experienced worsening kidney function due to a fungal obstruction. Attempts to clear the blockage led to a severe infection and graft artery rupture, highlighting potential risks of interventions.

Area of Science:

  • Nephrology
  • Transplantation
  • Mycology

Background:

  • Diabetic nephropathy is a leading cause of end-stage renal disease.
  • Renal transplantation is a common treatment for end-stage renal disease in diabetic patients.
  • Candiduria can occur in immunocompromised patients, including transplant recipients.

Observation:

  • A diabetic renal transplant patient presented with recurrent elevations in serum creatinine.
  • The patient had candiduria and an intermittently obstructing fungal ball in the urinary tract.
  • Initial attempts at nephrostomy tube placement for local treatment were unsuccessful.

Findings:

  • The fungal infection extended to the perirenal space, causing renal graft artery rupture.
  • Percutaneous nephrostomy was associated with increased risk of renal and extrarenal tissue infection.
  • Fatal complications, including vascular anastomosis infection, are possible.

Implications:

  • This case underscores the potential for severe complications from fungal ball obstruction in renal transplant recipients.
  • Interventions like percutaneous nephrostomy may carry risks of disseminating infection.
  • Vigilant monitoring and prompt, appropriate treatment of candiduria are crucial in transplant patients.

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