Cavitary lung lesion 6 years after renal transplantation

作     者：Arun Kumar Subbiah Sudheer Arava Soumita Bagchi Karan Madan Chandan J Das Sanjay Kumar Agarwal 

作者机构：Department of NephrologyAll India Institute of Medical Sciences Department of PathologyAll India Institute of Medical Sciences Department of Pulmonary medicine and sleep disordersAll India Institute of Medical Sciences Department of RadiologyAll India Institute of Medical Sciences 

出 版 物：《World Journal of Transplantation》 (世界移植杂志)

年 卷 期：2016年第6卷第2期

页      面：447-450页

学科分类：10[医学] 

主　　题：Lung cavity Immunosuppression Renal transplantation 

摘      要：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.