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Biopsy-proven fungal pyelonephritis complicating delayed graft function in a renal transplant patient

Aaron Jesuthasan1, Candice Roufosse2,3, Arun Ramaswami4

  • 1Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK aaronjesuthasan@gmail.com.

BMJ Case Reports
|February 10, 2023
PubMed

Insights

Delayed graft function (DGF) after kidney transplant can rarely be caused by fungal infections. Early diagnosis via biopsy is crucial for timely antifungal treatment and preventing graft loss.

Area of Science:

  • Nephrology
  • Transplantation Immunology
  • Mycology

Background:

  • Delayed graft function (DGF) is a frequent complication post-renal transplantation.
  • Invasive fungal infections are a rare but serious cause of DGF.
  • Prompt diagnosis of fungal infections in transplant recipients is critical to prevent severe outcomes.

Observation:

  • A case of fungal pyelonephritis was observed in a renal transplant patient.
  • This infection complicated the patient's condition, potentially causing DGF and dialysis dependence.
  • Standard investigations for DGF were largely unremarkable in this case.

Findings:

  • Renal transplant biopsy proved essential for confirming the diagnosis of fungal pyelonephritis.
  • Early identification of invasive fungal infections is key in managing transplant complications.
  • Biopsy findings were critical when other diagnostic methods were inconclusive.

Implications:

  • Timely antifungal treatment, guided by biopsy, can lead to improved patient outcomes.
  • Early intervention can preserve renal allograft function and reduce long-term dialysis needs.
  • This case underscores the importance of considering rare etiologies like fungal infections in DGF.
Keywords:
Renal interventionRenal transplantationUrinary tract infections

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