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Disseminated histoplasmosis presenting as urinary tract obstruction in a renal transplant recipient
K R Superdock1, J S Dummer, M O Koch
1Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.
Abstract:
Disseminated histoplasmosis occasionally involves the kidney, but the infection usually does not cause either urinary symptoms or a decrease in renal function. We present a case of disseminated histoplasmosis in a renal transplant recipient who presented with urinary obstruction in the allograft from a sloughed renal papilla infected with the fungus. At the same time the patient had chronic meningitis from Histoplasma capsulatum. The literature on renal involvement with histoplasmosis is reviewed.
Insights
Disseminated histoplasmosis can affect kidneys, but this case highlights urinary obstruction in a renal transplant recipient due to fungal infection. The study reviews renal histoplasmosis literature.
Area of Science:
- Nephrology
- Infectious Diseases
- Transplantation Immunology
Background:
- Disseminated histoplasmosis rarely causes renal dysfunction or urinary symptoms.
- Renal involvement in histoplasmosis typically presents asymptomatically.
- Histoplasma capsulatum is an endemic fungus causing opportunistic infections.
Observation:
- A renal transplant recipient developed urinary obstruction in the allograft.
- The obstruction was caused by a sloughed renal papilla infected with Histoplasma capsulatum.
- The patient also had chronic meningitis due to Histoplasma capsulatum.
Findings:
- This case demonstrates a rare presentation of renal histoplasmosis causing urinary obstruction.
- Fungal infection of the renal papilla can lead to significant allograft complications.
- Disseminated histoplasmosis requires consideration of diverse organ involvement.
Implications:
- Highlights the importance of considering fungal infections in transplant recipients with unexplained renal complications.
- Suggests that renal papilla necrosis is a potential mechanism for urinary obstruction in disseminated histoplasmosis.
- Emphasizes the need for comprehensive evaluation in immunocompromised patients with Histoplasma infections.