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Successful treatment of infective endocarditis in four kidney transplant recipients

Fatemeh Pour-Reza-Gholi1, Farhat Farrokhi, Behzad Einollahi

  • 1Department of Kidney Transplantation, Shaheed Labbafinejad Medical Center, Shaheed Beheshti Medical University, Tehran, Iran. pourrezagholi@unrc.ir

Iranian Journal of Kidney Diseases
|April 10, 2009
PubMed

Insights

Infective endocarditis (IE) in kidney transplant recipients is serious but manageable. Early diagnosis and treatment, including antibiotics and surgery, can preserve both the patient and the transplanted kidney.

Area of Science:

  • Nephrology
  • Transplantation Immunology
  • Infectious Diseases

Background:

  • Infective endocarditis (IE) poses a significant threat to kidney transplant recipients, often resulting in graft loss and increased mortality.
  • Management of IE in this vulnerable population requires careful consideration of immunosuppression and potential complications.

Observation:

  • This study reports on four kidney transplant recipients successfully treated for IE.
  • Causative agents identified included Enterococcus and group D Streptococcus, with one case culture-negative.
  • Diagnosis was confirmed using at least two major Duke criteria for IE.

Findings:

  • Despite a transient rise in serum creatinine in three patients, no instances of kidney allograft rejection were observed during follow-up.
  • Aggressive antibiotic therapy and timely surgical intervention were key components of successful management.

Implications:

  • Prompt diagnosis and comprehensive treatment, including surgical options, are crucial for preserving both the patient's life and the kidney allograft.
  • Further research into recurrent infections and co-existing conditions like cytomegalovirus in these patients is recommended.

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