Disseminated Histoplasmosis, Pulmonary Tuberculosis, and Cytomegalovirus Disease in a Renal Transplant Recipient after Infection with SARS-CoV-2
Introduction. Infection with SARS-CoV-2 increases the risk of acute graft dysfunction (AGD) in renal transplant recipients (RTR), and the risk of concurrently presenting with opportunistic infections is also increased. There is no current consensus on the management of immunosuppression during SARS-...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Case Reports in Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2022/8042168 |
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| author | Carvallo-Venegas Mauricio Fuentes-López Elsa Angélica Andrade-Ortega Antonio de Jesús Torres-Baranda José Rodrigo Carrasco-Carrizosa Aldo Cerrillos-Gutierrez José Ignacio Andrade-Sierra Jorge |
| author_facet | Carvallo-Venegas Mauricio Fuentes-López Elsa Angélica Andrade-Ortega Antonio de Jesús Torres-Baranda José Rodrigo Carrasco-Carrizosa Aldo Cerrillos-Gutierrez José Ignacio Andrade-Sierra Jorge |
| author_sort | Carvallo-Venegas Mauricio |
| collection | DOAJ |
| description | Introduction. Infection with SARS-CoV-2 increases the risk of acute graft dysfunction (AGD) in renal transplant recipients (RTR), and the risk of concurrently presenting with opportunistic infections is also increased. There is no current consensus on the management of immunosuppression during SARS-CoV-2 infection in RTR. Case Presentation. A 35-year-old male RTR from a living related donor presented with SARS-CoV-2 infection (January 2021). Two months later, despite alterations to his immunosuppression regimen (tacrolimus (TAC) was reduced by 50%, and the mycophenolic acid (MMF) was suspended with the remission of symptoms), the patient presented with pulmonary tuberculosis, pneumonia due to respiratory syncytial virus (RSV), cytomegalovirus (CMV) pneumonitis, and histoplasmosis (HP). Management was initiated with antituberculosis medications, ganciclovir, antibiotics, and liposomal amphotericin B, and the immunosuppressants were suspended, yet the patient’s evolution was catastrophic and the outcome fatal. Conclusion. We recommend that in RTR post-COVID-19, the immunosuppression regimen should be gradually reinstated along with strict vigilance in observing for highly prevalent coinfections (TB, HP, and CMV). |
| format | Article |
| id | doaj-art-52f7af0c478b48b99efdbba31fa627db |
| institution | Kabale University |
| issn | 2090-6951 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Transplantation |
| spelling | doaj-art-52f7af0c478b48b99efdbba31fa627db2025-02-03T06:04:54ZengWileyCase Reports in Transplantation2090-69512022-01-01202210.1155/2022/8042168Disseminated Histoplasmosis, Pulmonary Tuberculosis, and Cytomegalovirus Disease in a Renal Transplant Recipient after Infection with SARS-CoV-2Carvallo-Venegas Mauricio0Fuentes-López Elsa Angélica1Andrade-Ortega Antonio de Jesús2Torres-Baranda José Rodrigo3Carrasco-Carrizosa Aldo4Cerrillos-Gutierrez José Ignacio5Andrade-Sierra Jorge6Department of Nephrology and Organ Transplant UnitDepartment of Nephrology and Organ Transplant UnitDepartment of MicrobiologyDepartment of MicrobiologyDepartment of Respiratory DiseasesDepartment of Nephrology and Organ Transplant UnitDepartment of Nephrology and Organ Transplant UnitIntroduction. Infection with SARS-CoV-2 increases the risk of acute graft dysfunction (AGD) in renal transplant recipients (RTR), and the risk of concurrently presenting with opportunistic infections is also increased. There is no current consensus on the management of immunosuppression during SARS-CoV-2 infection in RTR. Case Presentation. A 35-year-old male RTR from a living related donor presented with SARS-CoV-2 infection (January 2021). Two months later, despite alterations to his immunosuppression regimen (tacrolimus (TAC) was reduced by 50%, and the mycophenolic acid (MMF) was suspended with the remission of symptoms), the patient presented with pulmonary tuberculosis, pneumonia due to respiratory syncytial virus (RSV), cytomegalovirus (CMV) pneumonitis, and histoplasmosis (HP). Management was initiated with antituberculosis medications, ganciclovir, antibiotics, and liposomal amphotericin B, and the immunosuppressants were suspended, yet the patient’s evolution was catastrophic and the outcome fatal. Conclusion. We recommend that in RTR post-COVID-19, the immunosuppression regimen should be gradually reinstated along with strict vigilance in observing for highly prevalent coinfections (TB, HP, and CMV).http://dx.doi.org/10.1155/2022/8042168 |
| spellingShingle | Carvallo-Venegas Mauricio Fuentes-López Elsa Angélica Andrade-Ortega Antonio de Jesús Torres-Baranda José Rodrigo Carrasco-Carrizosa Aldo Cerrillos-Gutierrez José Ignacio Andrade-Sierra Jorge Disseminated Histoplasmosis, Pulmonary Tuberculosis, and Cytomegalovirus Disease in a Renal Transplant Recipient after Infection with SARS-CoV-2 Case Reports in Transplantation |
| title | Disseminated Histoplasmosis, Pulmonary Tuberculosis, and Cytomegalovirus Disease in a Renal Transplant Recipient after Infection with SARS-CoV-2 |
| title_full | Disseminated Histoplasmosis, Pulmonary Tuberculosis, and Cytomegalovirus Disease in a Renal Transplant Recipient after Infection with SARS-CoV-2 |
| title_fullStr | Disseminated Histoplasmosis, Pulmonary Tuberculosis, and Cytomegalovirus Disease in a Renal Transplant Recipient after Infection with SARS-CoV-2 |
| title_full_unstemmed | Disseminated Histoplasmosis, Pulmonary Tuberculosis, and Cytomegalovirus Disease in a Renal Transplant Recipient after Infection with SARS-CoV-2 |
| title_short | Disseminated Histoplasmosis, Pulmonary Tuberculosis, and Cytomegalovirus Disease in a Renal Transplant Recipient after Infection with SARS-CoV-2 |
| title_sort | disseminated histoplasmosis pulmonary tuberculosis and cytomegalovirus disease in a renal transplant recipient after infection with sars cov 2 |
| url | http://dx.doi.org/10.1155/2022/8042168 |
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