Opportunistic infections in a renal transplant recipient

Abstract

With the present progress in transplantation procedures, there is an improvement in patient and allograft survival. However, the immunosuppression necessary to sustain the allograft predisposes these transplant recipients to infection, which is now a significant cause of morbidity and mortality. We describe a case of a 30-year-old renal transplant recipient with two opportunistic infections, namely, primary cutaneous aspergillosis and intestinal tuberculosis, with terminal enterococcal pleuritis and peritonitis. Control of the degree of immunosuppression, and prompt recognition and treatment of infection are vital for successful organ transplantation.

Keywords: Aspergillosis; opportunistic infections; renal transplantation.; tuberculosis.

Figure 1

Photomicrograph showing dark brown, septate fungal hyphae with acuteangle branching (Haematoxylin and Eosin x 1000).

Figure 2

Photomicrograph showing fungal hyphae in the keratin layer of the epidermis, highlighted by periodic acid Schiff staining (magenta colour) (Periodic acid Schiff x 400).

Figure 3

A) Photomicrograph showing ulcerated intestinal mucosa with dense inflammatory cell infiltration (Haematoxylin and Eosin x 100); B) dense infiltration by neutrophils and lymphocytes, in the intestinal wall (Haematoxylin and Eosin x 400).

Figure 4

Photomicrograph showing strong positivity for acid fast bacilli (Ziehl-Neelsen stain x 1000).