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Organo Oficial de la Sociedad Mexicana de Urología

2022, Number 4

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Rev Mex Urol 2022; 82 (4)

Kidney transplant with Scedosporium apiospermun infection: case report and literature review

Rabadán-Márquez P, Bautista-Vidal C, España-Navarro R

Language: Spanish
References: 29
Page:
PDF size: 703.57 Kb.


ABSTRACT

Case report: A 53-year-old female with a deceased-donor kidney transplant who was receiving quadruple sequential immunosuppressive therapy, with a delayed graft function in her immediate postoperative period, and no need for dialysis. Two months later, the patient was hospitalized due to sudden eye pain, low grade fever and myalgia. A nuclear magnetic resonance showed space occupying injuries in the CNS, suggesting an infectious process and diffuse graft pyelonephritis, requiring a transplantectomy. The patient died 24 hours after the surgery despite the antifungal therapy. The kidney tissue culture revealed Scedosporium apiospermun growth.
Relevance: The case highlights the importance of knowing and being able to manage infections in a timely manner, given the growing number of transplanted patients with immunosuppressive therapy.
Clinical implications: The Scedosporium apiospermun is an emerging, ubiquitous, and opportunistic fungus that causes systemic infections in immunocompromised patients that may produce up to 90% of mortality, and local infections that requires surgical debridement and longterm antifungal treatment with voriconazole for at least 3 months.
Conclusions: Despite this type of infection not being frequently seen, it demands a quick differential diagnosis and an appropriate treatment, given the potential mortality and morbidity outcomes.


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