scholarly journals Different clinical presentations of two renal transplant recipients with Coronavirus Disease 2019: a case report

2020 ◽  
Author(s):  
Jing Li ◽  
Gang Chen ◽  
chao chen
Keyword(s):  
Renal Transplant ◽  
Antiviral Treatment ◽  
Organ Transplant ◽  
Severe Pneumonia ◽  
Disease Spread ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Clinical Presentations ◽  
The Impact

Abstract Background: The Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome Coronavirus-2 has spread rapidly worldwide and disease spread is currently increasing. The clinical picture of transplant recipients and the effect of the anti-rejection immunosuppressive regimens on the clinical course of COVID-19 are lacking.Case presentation: We report two cases of COVID-19infection in renal transplant recipients with variable clinical presentations. The first patient presented with mild respiratory symptoms and a stableclinical course. The second patient had more severe clinical characteristics and presented with severe pneumonia and multi-organ failure. Both patients received a combination therapy including antiviral treatment and reducedimmunosuppressiontherapy and finally recovered.Conclusions: We report COVID-19 infectionin two renal transplant recipients with a favorable outcome but different clinical courses, which may provide a reference valuefor treating such patients. Additional data are needed to gain a better understanding of the impact of immunosuppressive therapy on the clinical presentation, severity, and outcome of COVID-19in solid organ transplant recipients.

scholarly journals Different clinical presentations of two renal transplant recipients with coronavirus disease 2019: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jing Li ◽  
Gang Chen ◽  
Mingmin Zhang ◽  
Shenghao Tu ◽  
Chao Chen
Keyword(s):  
Renal Transplant ◽  
Antiviral Treatment ◽  
Reference Value ◽  
Severe Pneumonia ◽  
Disease Spread ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Case Presentation ◽  
Clinical Presentations ◽  
Immunosuppression Therapy

Abstract Background The Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome Coronavirus-2 has spread rapidly worldwide and disease spread is currently increasing. Data on the clinical picture of transplant recipients and management of the anti-rejection immunosuppressive therapy on COVID-19 infection are lacking. Case presentation We report two cases of COVID-19 infection in renal transplant recipients with variable clinical presentations. The first patient presented with mild respiratory symptoms and a stable clinical course. The second patient had more severe clinical characteristics and presented with severe pneumonia and multi-organ failure. Both patients received a combination therapy including antiviral treatment and reduced immunosuppression therapy and finally recovered. Conclusions We report COVID-19 infection in two renal transplant recipients with a favorable outcome but different clinical courses, which may provide a reference value for treating such patients.

scholarly journals Lower Respiratory Tract Infection in a Renal Transplant Recipient: Do not Forget Metapneumovirus

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
N. Noel ◽  
B. Rammaert ◽  
J. Zuber ◽  
N. Sayre ◽  
M. F. Mamzer-Bruneel ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Organ Transplant ◽  
Detection Methods ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Solid Organ Transplant Recipients

Human metapneumovirus (hMPV) is emerging as a cause of a severe respiratory tract infection in immunocompromised patients. hMPVpneumonia has only been seldom reported in nonpulmonary solid organ transplanted patients, such as renal transplant recipients. We report here a case of a 39-year-old patient presenting with fever, cough, and interstitial opacities on CT scan diagnosed as a nonsevere hMPVpneumonia 11 years after a renal transplantation. Infection resolved spontaneously. Differential diagnosis withPneumocystispneumonia was discussed. We review the medical literature and discuss clinical presentation and detection methods that can be proposed in solid organ transplant recipients.

scholarly journals Deceptively asymptomatic cryptococcaemia in a renal transplant recipient: the lull before a storm

2019 ◽  
Vol 12 (4) ◽  
pp. e228115 ◽  
Author(s):  
Vivek Sood ◽  
Navin Pattanashetti ◽  
Raja Ramachandran ◽  
Krishan Lal Gupta
Keyword(s):  
Renal Transplant ◽  
Ischaemic Stroke ◽  
Opportunistic Infections ◽  
Organ Transplant ◽  
Induction Phase ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Intracranial Vessel ◽  
Solid Organ Transplant Recipients

Cryptococcal infection constitutes around 3% of opportunistic infections in solid organ transplant recipients. Most common organ affected in renal transplant recipients (RTRs) is central nervous system and usually presents with chronic meningoencephalitis (CME). Ischaemic stroke as a consequence of cryptococcal meningoencephalitisis rare and possibly due to the involvement of intracranial vessel by exudates causing vasculitis-related thrombosis. In this context, we describe an unusual case of asymptomatic cryptococcaemia in an RTR, progressing on to acute ischaemic stroke secondary to acute CME with near complete neurological recovery following timely diagnosis, early and appropriate antifungal treatment. The index case attempts to re-emphasise the significance of mandatory screening required to exclude the possibility of dissemination of cryptococcaemia in RTRs besides highlighting the requirement of prolonged induction phase with combination therapy, particularly in presence of stroke.

scholarly journals Human Adenovirus 11 in 2 Renal Transplant Recipients: Suspected Donor-Derived Infection

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Amy C Sherman ◽  
Xiaoyan Lu ◽  
Eileen Schneider ◽  
Amelia Langston ◽  
Carla L Ellis ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Clinical Course ◽  
Treatment Options ◽  
Organ Transplant ◽  
Human Adenovirus ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Sequence Identity ◽  
Clinical Syndromes

Abstract Background Human adenovirus (HAdV) infections can lead to high mortality in solid organ transplant (SOT) recipients, with rare reports of donor-derived infection. Methods Two renal transplant recipients with HAdV-11 infection who received kidneys from the same donor are described. Whole-genome sequencing (WGS) was performed. Results WGS showed 100% nucleotide sequence identity for the 2 HAdV-11 isolates. The patients presented with distinct clinical syndromes, and both were treated with brincidofovir. Conclusions Donor-derived HAdV infection is presumed to be low; however, disseminated HAdV in SOT recipients can be severe, and clinicians should be aware of the clinical course and treatment options.

scholarly journals Gastric Mucormycosis in a Renal Transplant Patient Treated with Isavuconazole Monotherapy

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Imran Gani ◽  
Atbin Doroodchi ◽  
Kristina Falkenstrom ◽  
Holly Berry ◽  
Won Lee ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Amphotericin B ◽  
Organ Transplant ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Mortality And Morbidity ◽  
Presenting Symptoms ◽  
Solid Organ Transplant Recipients ◽  
Upper Gastrointestinal

Gastrointestinal mucormycosis is a rare infection in solid organ transplant recipients. Our patient, a 79-year-old male, presented with severe dysphagia and odynophagia about 2 weeks after receiving a renal transplant. An upper gastrointestinal (UGI) endoscopy revealed esophagitis and gastric ulceration, the cultures from which grew Rhizopus species. A usual treatment strategy should include Amphotericin B as monotherapy or in combination with Posaconazole or Isavuconazole for such infections. Our patient was treated with Isavuconazole monotherapy, in an effort to minimize renal toxicity from Amphotericin B to the new allograft. Unique to our case was a successful clinical response and resolution of UGI lesions with Isavuconazole monotherapy. Due to the vagueness of presenting symptoms, such infections can be easily missed in an immunocompromised patient which can have tragic outcomes. Prompt diagnosis and modulation of immunosuppression are essential to decrease mortality and morbidity. Isavuconazole is a novel agent and can be used as a monotherapy for such infections, especially in renal transplant recipients.

The Significance and Impact of Screening Preservation Fluid Cultures in Renal Transplant Recipients

2020 ◽  
pp. 152692482097860
Author(s):  
Anesia Reticker ◽  
Alicia Lichvar ◽  
Meghan Walsh ◽  
Alan E. Gross ◽  
Shree Patel
Keyword(s):  
Renal Transplant ◽  
Microbial Growth ◽  
Kidney Transplant Recipient ◽  
Antimicrobial Treatment ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Skin Flora ◽  
The Impact ◽  
Culture Positive

Introduction: Infectious complications can be a major cause of morbidity and mortality in solid organ transplant recipients. Preservation fluid is necessary to maintain organ viability but may serve as a vector or infection. The utility of screening preservation fluid routinely for microbial growth and the impact of culture-positive preservation fluid is controversial. Research Question: What is the clinical impact of a culture positive preservation fluid in a kidney transplant recipient? Design: This retrospective study was performed to define the incidence of post-operative infection related to PF and examine the negative sequelae of culture-positive PF. One hundred and fifty-two deceased donor renal transplant recipients from January 2015 to December 2017 were included for analysis. Results: Overall, 67% of patients (102/152) received an allograft from a culture-positive PF. Nearly 80% of microbial growth was consistent with skin flora, and coagulase-negative staphylococci was the most frequently isolated organism (56%). Sixty-seven percent of patients (68/102) with culture-positive PF received antimicrobial treatment for an average duration of 5 days. There was no difference in the incidence of infection between patients with culture positive PF compared to culture-negative PF. Furthermore, there were no cases of infection related to PF regardless of whether culture-positive PF was treated or untreated. The incidence of subsequent C. difficile infection and multidrug-resistant organisms was similar. Discussion: This study suggests antimicrobial treatment for culture positive PF may not be necessary with pathogens that are common contaminants and of low virulence. Interventional studies are needed to validate this strategy.

scholarly journals Impaired Humoral Response in Renal Transplant Recipients to SARS-CoV-2 Vaccination with BNT162b2 (Pfizer-BioNTech)

Viruses ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 756
Author(s):  
Johannes Korth ◽  
Michael Jahn ◽  
Oliver Dorsch ◽  
Olympia Evdoxia Anastasiou ◽  
Burkhard Sorge-Hädicke ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Messenger Rna ◽  
Organ Transplant ◽  
Humoral Response ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Transplant Patients ◽  
Vulnerable Patients ◽  
Individual Vaccination

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has a major impact on transplant recipients, with mortality rates up to 20%. Therefore, the effect of established messenger RNA (mRNA)-based SARS-CoV-2 vaccines have to be evaluated for solid organ transplant patients (SOT) since they are known to have poor responses after vaccination. We investigated the SARS-CoV-2 immune response via SARS-CoV-2 IgG detection in 23 renal transplant recipients after two doses of the mRNA-based SARS-CoV-2 vaccine BNT162b2 following the standard protocol. The antibody response was evaluated once with an anti-SARS-CoV-2 IgG CLIA 15.8 +/− 3.0 days after the second dose. As a control, SARS-CoV-2 IgG was determined in 23 healthcare workers (HCW) and compared to the patient cohort. Only 5 of 23 (22%) renal transplant recipients were tested positive for SARS-CoV-2 IgG antibodies after the second dose of vaccine. In contrast, all 23 (100%) HCWs were tested positive for antibodies after the second dose. Thus, the humoral response of renal transplant recipients after two doses of the mRNA-based vaccine BNT162b2 (Pfizer-BioNTech, Kronach, Germany) is impaired and significantly lower compared to healthy controls (22% vs. 100%; p = 0.0001). Individual vaccination strategies might be beneficial in these vulnerable patients.

Detection of Toxoplasma Gondii Antibodies and DNA Among Renal Transplant Recipient and blood donor in Khartoum State, Sudan

2021 ◽  
pp. 135-141
Author(s):  
Elghazali Mohammed ◽  
Mustafa Yassin ◽  
Khalid Anan ◽  
Dina N Abdelrahman ◽  
Abdelrahim M. ElHussein ◽  
...  
Keyword(s):  
Toxoplasma Gondii ◽  
Renal Transplant ◽  
Transplant Recipient ◽  
Renal Transplant Recipient ◽  
Blood Donor ◽  
Blood Donors ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Toxoplasma Gondii Infection

Background and Aim: Toxoplasma gondii infection arises in transplant recipient groups, but at varying frequencies. Reactivation of latent T. gondii infection in transplant patients is uncommon, but does occur. The incidence of reactivation is greater in patient groups receiving more aggressive immunosuppressive therapy. Early diagnosis and treatment should be considered in T. gondii-antibody-positive patients subjected to solid organ transplantation. The aim of this study was to estimate the seroprevalence of Toxoplasma gondii infection in renal transplant recipients in Khartoum, Sudan, using serological and molecular methods. Methods: This was a descriptive cross sectional, hospital based study, blood sample were collected from 108 participants; out of them 58 renal transplant recipient individuals and 50 healthy Blood donor attending Sudanese Kidney Association Hospital and Sudan Heart Center Blood Bank. Demographic data were collected by structured questionnaire. All samples were tested for anti-Toxoplasma IgG and IgM antibodies using ELISA, and PCR for detection of Toxoplasma DNA was performed. Results: The seropositivity of IgG anti-T. gondii antibodies was higher in renal transplant recipients than in blood donors (36.2% vs 32.0%). Anti-toxoplasma IgM was positive in one renal transplant recipient individual (1.70%), and no samples exhibit reactive IgM antibody for blood donors. None of the samples exhibited positivity to T.gondii DNA. Conclusion: the study showed a relatively high seroprevalence of T.gondii antibodies in renal transplant recipients and blood donor volunteers, on the other hand, the prevalence was much higher in the study conducted in pregnant woman in Sudan. Our study highlighted that asymptomatic blood donors, may constitute a significant risk of transmitting toxoplasmosis to susceptible recipients.

Sign in / Sign up

Export Citation Format

Share Document