Multifocal Cryptococcus Neoformans Osteomyelitis in a Kidney Transplant Recipient
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Updated: May 14, 2025

Multifocal Electroretinograms
Published on: December 4, 2011
Sanshriti Chauhan1, Sanjeev Gulati1, Gopendro Singh Naorem2
1Department of Nephrology, Fortis Health Care Limited, New Delhi, India.
Abstract:
Cryptococcal infections are notoriously difficult to diagnose and have been associated with high morbidity and mortality. Cryptococcus neoformans presenting as osteomyelitis is an unexpected clinical scenario in the transplant ward. A young male who underwent spousal kidney donor transplantation 16 months ago presented with painful and ulcerated soft tissue in upper and lower limbs which were diagnosed as cryptococcus osteomyelitis. He was managed with surgical debridement, liposomal amphotericin B, flucytosine and reduction in maintenance immunosuppression (IS). To our knowledge this is the first reported case of multifocal cryptococcus osteomyelitis in a kidney transplant recipient.
Insights
Cryptococcus osteomyelitis is a rare complication in kidney transplant recipients. This case highlights multifocal bone infection in a young male, successfully treated with antifungals and reduced immunosuppression.
Area of Science:
- Infectious Diseases
- Nephrology
- Surgical Pathology
Background:
- Cryptococcal infections pose diagnostic challenges and are linked to significant morbidity and mortality.
- Osteomyelitis caused by Cryptococcus neoformans is an unusual presentation, particularly in immunocompromised patients.
Observation:
- A young male kidney transplant recipient presented with painful, ulcerated soft tissue in his limbs.
- Imaging and biopsy confirmed multifocal osteomyelitis caused by Cryptococcus neoformans.
Findings:
- The patient was treated with surgical debridement, liposomal amphotericin B, and flucytosine.
- A reduction in maintenance immunosuppression was also administered as part of the management strategy.
Implications:
- This is the first reported case of multifocal cryptococcal osteomyelitis in a kidney transplant recipient.
- Early diagnosis and multidisciplinary management are crucial for favorable outcomes in such rare infections.
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