A Case of Intermittent Fever a Decade After Renal Transplantation

Area of Science:

• Medicine
• Infectious Diseases
• Transplantation

Background:

• Disseminated histoplasmosis is a severe complication following organ transplantation.
• It is rare, even in endemic areas, and diagnosis can be difficult due to nonspecific symptoms.
• Post-transplant lymphoproliferative disorder (PTLD) can mimic disseminated histoplasmosis.

Purpose of the Study:

• To report a rare case of disseminated histoplasmosis presenting 10 years after kidney transplantation.
• To emphasize the diagnostic challenges in immunocompromised patients.
• To highlight the importance of considering fungal infections in transplant recipients with prolonged nonspecific symptoms.

Main Methods:

• Case report of a kidney transplant recipient.
• Clinical presentation with intermittent fever and lethargy.
• Diagnostic workup including mediastinal lymph node biopsy and fungal tissue culture.

Main Results:

• The patient presented with intermittent fever 10 years post-kidney transplant.
• Initial suspicion was PTLD.
• Diagnosis confirmed as disseminated histoplasmosis via biopsy and culture.

Conclusions:

• Disseminated histoplasmosis can occur late after kidney transplantation.
• Nonspecific symptoms like intermittent fever warrant thorough investigation in transplant recipients.
• Fungal tissue culture is crucial for diagnosing disseminated histoplasmosis in this population.