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Fatal case of Aspergillus coinfection in a renal transplant recipient suffering from cytomegalovirus pneumonitis (Case Report)
Author(s) -
SIU YUIPONG,
LEUNG KAYTAI,
TONG MATTHEW KAHANG,
KWOK YUKLUNG,
WONG PIKKEI,
KWAN TZEHOI
Publication year - 2005
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/j.1440-1797.2005.00459.x
Subject(s) - medicine , coinfection , pneumonitis , fulminant , cytomegalovirus , chest radiograph , aspergillosis , bronchoalveolar lavage , respiratory failure , septic shock , pneumonia , gastroenterology , lung , immunology , sepsis , human immunodeficiency virus (hiv) , viral disease , herpesviridae
SUMMARY: Cytomegalovirus (CMV) disease is common in postrenal transplant recipients, and may predispose the patients to secondary bacterial or fungal infections. However, simultaneous coinfection is rare and often makes diagnosis difficult. We report a case of CMV pneumonitis in a renal transplant recipient presenting with elevated CMV pp 65 antigen level and abnormal chest radiograph. Despite potent and broad‐spectrum antimicrobial therapy, his condition deteriorated rapidly – he soon went into respiratory failure, septic shock and died several days later. Transbronchial biopsy and bronchoalveolar lavage obtained before the patient's death showed evidence of invasive pulmonary aspergillosis with concomitant CMV pneumonitis. High index of suspicion and early and empirical initiation of antifungal therapy may be necessary for successful management of fulminant pneumonia in solid organ transplant recipients.