Cryptococcosis Presenting as a Colonic Ulcer in a Kidney Transplant Recipient: A Case Report

Area of Science:

• Nephrology
• Infectious Diseases
• Gastroenterology

Background:

• Chagas disease poses unique challenges in immunocompromised patients, particularly after solid organ transplantation.
• Kidney transplant recipients require lifelong immunosuppression, increasing susceptibility to opportunistic infections.

Observation:

• A 59-year-old kidney transplant recipient with a history of Chagas disease presented with a persistent 2-month history of diarrhea.
• Colonoscopy revealed a significant colonic ulcer, prompting a broad differential diagnosis including infections, inflammatory conditions, and malignancy.

Findings:

• Microscopic examination of the colon ulcer tissue confirmed the presence of Cryptococcus neoformans.
• The patient's infection was successfully treated with a course of amphotericin B followed by oral fluconazole.

Implications:

• This case highlights cryptococcosis as a rare but potential cause of colonic ulcers in immunocompromised patients, including kidney transplant recipients.
• Early diagnosis and appropriate antifungal therapy are crucial for managing opportunistic infections in transplant recipients.
• Consideration of fungal etiologies is important in the differential diagnosis of gastrointestinal pathology in this patient population.