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Post kidney transplant histoplasmosis: An under-recognized diagnosis in India
Abhyudaysingh Rana1, Camille N Kotton2, Amit Mahapatra1
1Department of Nephrology and Renal Transplant Medicine, Medanta - The Medicity, Gurguram, Haryana, India.
Abstract:
Histoplasmosis is an invasive mycosis caused by fungus Histoplasma capsulatum. Clinical features of histoplasmosis are often nonspecific, but patients with disseminated infection may present with severe manifestations posing an increasing threat to patients with various immunocompromised conditions. It is often misdiagnosed as tuberculosis in endemic regions leading to high mortality. There is under-reporting of histoplasmosis in solid organ transplant from India undermining its actual incidence and impact. As a result of the potentially fatal nature of the disease, careful evaluation with tissue diagnosis is recommended. We present a series of five cases of disseminated histoplasmosis in renal transplant recipients from our centre, highlighting its significance as differential diagnosis in this population. To our knowledge, this is the largest case series reported from India in renal transplant patients.
Insights
Disseminated histoplasmosis, a fungal infection, is a serious threat to renal transplant patients, often misdiagnosed and under-reported in India. Early diagnosis and tissue evaluation are crucial for this immunocompromised group.
Area of Science:
- Mycology
- Infectious Diseases
- Transplant Medicine
Background:
- Histoplasmosis, caused by Histoplasma capsulatum, is an invasive fungal infection.
- Clinical presentation can be nonspecific, mimicking other diseases like tuberculosis.
- Disseminated histoplasmosis poses a significant risk to immunocompromised individuals, particularly solid organ transplant recipients.
Observation:
- A case series of five renal transplant recipients with disseminated histoplasmosis from India is presented.
- This condition is under-reported in solid organ transplant recipients in India.
- The study highlights the significance of histoplasmosis as a differential diagnosis in this patient population.
Findings:
- Disseminated histoplasmosis can be fatal if not promptly diagnosed and treated.
- Tissue diagnosis is recommended for definitive evaluation.
- This case series represents the largest reported from India in renal transplant patients.
Implications:
- Increased awareness of histoplasmosis is needed among clinicians managing renal transplant recipients in India.
- Timely diagnosis can improve patient outcomes and reduce mortality.
- Further research into the incidence and management of histoplasmosis in transplant recipients in India is warranted.
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