13th Luso-Brazilian Transplantation Congress, 12th Portuguese Transplantation Congress and 1st Iberian Meeting of TransplantationCase reportA Rare Paracoccidioidomycosis Diagnosis in a Kidney Transplant Receptor: Case Report
Section snippets
Purpose
The purpose of this description is to report a rare case of a patient with a diagnosis of cervical pseudotumoral PCM who underwent a kidney transplantation 3 years ago.
Case Report
The patient (45-year-old man) received a transplanted kidney 3 years ago from a living related donor (sister), haplo-identical HLA, with no diagnosis for the cause of the end-stage renal failure, using as an immunosuppressant tacrolimus, mycophenolic acid, and corticosteroid. He was from Paraiba (the northeast region of Brazil), where he spent all of his childhood and the major part of his adult life, while living some years in Rio de Janeiro (southeast region of Brazil). Before renal failure,
Results
The patient had received sulfamethoxazole/trimethoprim for 39 days with no clinical improvement, and his compromised clinical state progressed with anemia and renal failure (creatinine 3.5). He was hospitalized in the intensive care unit after presenting with septic shock, severe pancytopenia, and hyponatremia. He died a few days later.
Conclusion
After analyzing cases of deep mycosis and kidney transplantation at the Ribeirão Preto Medical School/São Paulo, the authors found 24.3% included pulmonary involvement. In these cases, PCM was responsible for 3.6% of the total, and of the 3 PCM cases described, 1 had involvement of the digestive tract, with the diagnosis performed only on autopsy [7]. Infection in kidney-transplanted patients by Paracoccidioides brasiliensis is unusual, and in the few cases described in the literature, clinical
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