Case report: Histoplasmosis presenting as asymptomatic hypercalcemia detected on routine laboratory testing in a...

Area of Science:

• Nephrology
• Infectious Diseases
• Mycology

Background:

• Fungal infections are a concern in pediatric kidney transplant recipients, typically occurring within 6 months post-transplant.
• Hypercalcemia can complicate kidney transplantation, impacting graft function.

Observation:

• A 15-year-old kidney transplant recipient, 4 years post-transplant, presented with asymptomatic hypercalcemia and acute kidney injury.
• Diagnostic workup identified *Histoplasma capsulatum* infection (histoplasmosis) with pulmonary nodules.

Findings:

• The patient's hypercalcemia was refractory to initial medical management.
• Initiation of antifungal treatment led to the resolution of hypercalcemia and improved kidney function markers.

Implications:

• Histoplasmosis should be considered in the differential diagnosis of hypercalcemia in pediatric kidney transplant recipients, even years after transplantation.
• Early diagnosis and antifungal therapy are crucial for managing fungal infections and associated complications like hypercalcemia in this vulnerable population.