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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.
Abstract:
We report a case of a diabetic renal transplant patient with candiduria who developed repeated elevations in serum creatinine concentration due to an intermittently obstructing candida ball in the urinary tract. After unsuccessful attempts to place a nephrostomy tube for local irrigation and debulking, the renal graft artery ruptured secondary to extensive perirenal candida infection. Percutaneous nephrostomy may increase the risks of renal and extrarenal tissue infection with the potential for fatal complications such as infection of the vascular anastomosis.
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.