Fungal panniculitis in renal transplant recipients

Area of Science:

• Infectious Diseases
• Nephrology
• Dermatology

Background:

• Panniculitis, inflammation of subcutaneous fat, has diverse causes.
• In immunosuppressed individuals, particularly organ transplant recipients, infections are a primary cause of panniculitis.
• Fungal infections pose a significant risk in this patient population.

Observation:

• Two cases of renal transplant recipients presenting with fungal panniculitis are described.
• Case 1: A patient developed panniculitis with cryptococcosis, confirmed by biopsy and positive cryptococcal antigens in various bodily fluids, without meningitis.
• Case 2: Another patient presented with panniculitis and histoplasmosis, with a history of inadequately treated disseminated histoplasmosis.

Findings:

• Microscopic examination of biopsies revealed fungal elements consistent with panniculitis.
• Both patients were successfully treated with conventional amphotericin B therapy.
• Renal function remained stable in both cases throughout the treatment period.

Implications:

• Fungal panniculitis should be considered in immunosuppressed patients, especially renal transplant recipients, presenting with subcutaneous inflammatory lesions.
• Early diagnosis and appropriate antifungal therapy, such as amphotericin B, are crucial for favorable outcomes.
• This highlights the importance of vigilant monitoring for opportunistic fungal infections in transplant recipients.