Subbiah AK, Arava S, Bagchi S, Madan K, Das CJ, Agarwal SK. Cavitary lung lesion 6 years after renal transplantation. World J Transplant 2016; 6(2): 447-450 [PMID: 27358792 DOI: 10.5500/wjt.v6.i2.447]
Corresponding Author of This Article
Soumita Bagchi, Assistant Professor, Department of Nephrology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. soumita_bagchi@yahoo.co.in
Research Domain of This Article
Transplantation
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Arun Kumar Subbiah, Soumita Bagchi, Sanjay Kumar Agarwal, Department of Nephrology, All India Institute of Medical Sciences, New Delhi 110029, India
Sudheer Arava, Department of Pathology, All India Institute of Medical Sciences, New Delhi 110029, India
Karan Madan, Department of Pulmonary medicine and sleep disorders, All India Institute of Medical Sciences, New Delhi 110029, India
Chandan J Das, Department of Radiology, All India Institute of Medical Sciences, New Delhi 110029, India
Author contributions: All authors contributed to the management of the patient, conceptualizing, writing and revising the manuscript.
Institutional review board statement: The case report was exempted from ethics approval by the Institute Ethics Committee, AIIMS.
Informed consent statement: The patient involved in this study gave his informed consent authorizing use and disclosure of his anonymized health information.
Conflict-of-interest statement: All authors have no conflicts of interests to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Soumita Bagchi, Assistant Professor, Department of Nephrology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. soumita_bagchi@yahoo.co.in
Telephone: +91-987-1911744
Received: January 13, 2016 Peer-review started: January 15, 2016 First decision: March 1, 2016 Revised: March 29, 2016 Accepted: May 10, 2016 Article in press: May 11, 2016 Published online: June 24, 2016 Processing time: 161 Days and 21.6 Hours
Abstract
The differential diagnoses of a cavitary lung lesion in renal transplant recipients would include infection, malignancy and less commonly inflammatory diseases. Bacterial infection, Tuberculosis, Nocardiosis, fungal infections like Aspergillosis and Cryptococcosis need to be considered in these patients. Pulmonary cryptococcosis usually presents 16-21 mo after transplantation, more frequently in patients who have a high level of cumulative immunosuppression. Here we discuss an interesting patient who never received any induction/anti-rejection therapy but developed both BK virus nephropathy as well as severe pulmonary Cryptococcal infection after remaining stable for 6 years after transplantation. This case highlights the risk of serious opportunistic infections even in apparently low immunologic risk transplant recipients many years after transplantation.
Core tip: Here we discuss an interesting patient who never received any induction/anti-rejection therapy but developed both BK virus nephropathy as well as severe pulmonary Cryptococcal infection after remaining stable for 6 years after transplantation. This case highlights the risk of serious opportunistic infections even in apparently low immunologic risk transplant recipients many years after transplantation.
