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Fulminant Emphysematous Pyelonephritis by Candida glabrata in a Kidney Allograft

Clara Cases-Corona1, Amir Shabaka2, Andrea Gonzalez-Lopez1

  • 1Nephrology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain.

Nephron
|April 29, 2020
PubMed

Insights

Emphysematous pyelonephritis (EPN) is a rare kidney infection. A case report details a fungal EPN in a kidney transplant recipient linked to empagliflozin, necessitating transplant nephrectomy.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Transplantation

Background:

  • Emphysematous pyelonephritis (EPN) is a severe necrotizing kidney infection, rarely reported in kidney grafts.
  • Typically caused by Gram-negative or anaerobic bacteria, EPN is associated with diabetes mellitus (DM) and urinary tract abnormalities.

Observation:

  • This report details a unique case of EPN in a kidney allograft caused by Candida glabrata.
  • The patient, a 53-year-old with a history of DM, vesicoureteral reflux, and recurrent UTIs, developed EPN three weeks after initiating empagliflozin therapy.

Findings:

  • This is the first reported case of fungal EPN in a kidney graft.
  • The infection presented aggressively, leading to the urgent removal of the transplanted kidney (nephrectomy).

Implications:

  • This case highlights a potential, previously unreported complication of empagliflozin in kidney transplant recipients.
  • It underscores the importance of considering fungal etiologies and the role of SGLT2 inhibitors in EPN development within this vulnerable population.
Keywords:
Candida glabrataCandiduriaDiabetes mellitusEmpagliflozinFungal pyelonephritisKidney transplantUrinary tract infection

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