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Revista mexicana de urología
versión On-line ISSN 2007-4085versión impresa ISSN 0185-4542
Resumen
RABADAN-MARQUEZ, Pablo; BAUTISTA-VIDAL, Carlos y ESPANA-NAVARRO, Rodrigo. Kidney transplant with Scedosporium apiospermun infection: case report and literature review. Rev. mex. urol. [online]. 2022, vol.82, n.4, e06. Epub 13-Mar-2023. ISSN 2007-4085. https://doi.org/10.48193/revistamexicanadeurologa.v82i4.786.
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 long-term 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.
Palabras llave : Kidney transplant; opportunistic infection; Scedosporium apiospermun.