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Invasive fungal infections in renal allograft recipients

Vinita Agrawal1, R K Gupta, Manoj Jain

  • 1Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow. vinita@sgpgi.ac.in

Indian Journal of Pathology & Microbiology
|December 22, 2005
PubMed

Insights

Invasive fungal infections are a serious risk for kidney transplant patients, often caused by Candida and Aspergillus. Early diagnosis and managing risk factors like Cytomegalovirus infection are crucial for survival.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Mycology

Background:

  • Invasive fungal infections (IFIs) are a significant cause of illness and death in kidney transplant recipients.
  • A 15-year study reviewed 29 cases of IFIs among 1231 renal transplants.

Purpose of the Study:

  • To analyze the clinical characteristics, risk factors, and outcomes of invasive fungal infections in renal allograft recipients.
  • To highlight diagnostic methods and emphasize the need for early detection and management.

Main Methods:

  • Retrospective analysis of 29 cases of invasive mycoses diagnosed via histology and/or cytology.
  • Clinical data review, including time to infection, causative agents, risk factors, diagnostic techniques, and mortality.

Main Results:

  • The incidence of IFIs was 2.35% over 15 years.
  • Candida (45%) and Aspergillus (21%) were the most common fungi.
  • Key risk factors included Cytomegalovirus infection, diabetes mellitus, and acute rejection episodes.
  • Disseminated infections had a high mortality rate (80%).
  • Fine needle aspiration cytology, bronchoalveolar lavage, and esophageal brush smears facilitated diagnosis.

Conclusions:

  • Effective management of renal transplant recipients necessitates identifying risk factors and maintaining high clinical suspicion for fungal infections.
  • Prompt diagnosis through various cytological methods is vital.
  • Further research into antifungal prophylaxis is warranted to reduce morbidity and mortality.

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