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Invasive fungal infections in renal transplant recipients: about 11 cases
H Trabelsi1, S Néji, H Sellami
1Fungal and parasitic molecular biology laboratory, school of medicine, Sfax University, Sfax, Tunisia.
Unlabelled:
Invasive fungal infections are a major complication and an important cause of morbidity and mortality among solid organ transplant recipients. Their diagnosis is difficult and their prognosis is often pejorative.
Objective:
The aim of this study was to report the cases of invasive fungal infections in renal transplant recipients in Habib Bourguiba Sfax university hospital and to identify the main fungal agents.
Materials And Methods:
It is a retrospective study of invasive fungal infections in renal transplant recipient reported in our hospital from January 1995 to February 2013.
Results:
Invasive fungal infections were diagnosed in 11 cases (3.4%) among 321 renal transplant recipients. These infections included four cases of pneumocystosis, two cases of candidiasis, two cases of aspergillosis, two cases of cryptococcosis and one case of mucormycosis. There were six men and five women. The mean age was 37 years. The infection was late in 63% of cases (>3 months after transplantation). The prolonged corticosteroid and immunosuppressive therapy were the main risk factors (100%) followed by renal failure (45%), graft rejection (45%), broad spectrum antibiotics (45%), CMV infection (36%), neutropenia (36%) and dialysis (18%). The evolution under treatment was favourable only in two cases (18%).
Conclusion:
Invasive fungal infections are not common among kidney transplant recipients. However, they remain an important cause of morbidity and mortality in this group of patients. Prevention, early diagnosis and appropriate management are necessary to improve prognosis and reduce mortality rate.
Insights
Invasive fungal infections (IFIs) are rare but serious complications in kidney transplant recipients. Early diagnosis and management are crucial to improve patient outcomes and reduce mortality.
Area of Science:
- Nephrology
- Infectious Diseases
- Transplantation Immunology
Background:
- Invasive fungal infections (IFIs) are significant causes of morbidity and mortality in solid organ transplant recipients.
- Diagnosis of IFIs can be challenging, and their prognosis is often poor.
Purpose of the Study:
- To report cases of IFIs in renal transplant recipients at Habib Bourguiba Sfax University Hospital.
- To identify the primary fungal agents responsible for IFIs in this patient cohort.
Main Methods:
- A retrospective study was conducted.
- Data on IFIs in renal transplant recipients were collected from January 1995 to February 2013.
Main Results:
- 11 cases (3.4%) of IFIs were diagnosed in 321 renal transplant recipients.
- Common IFIs included pneumocystosis, candidiasis, aspergillosis, cryptococcosis, and mucormycosis.
- Prolonged corticosteroid and immunosuppressive therapy were major risk factors; only 18% of patients had a favorable treatment outcome.
Conclusions:
- IFIs are uncommon but critical complications in kidney transplant recipients, contributing to significant morbidity and mortality.
- Effective prevention, early diagnosis, and appropriate management strategies are essential to improve prognosis and reduce mortality rates in this vulnerable population.
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