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Disseminated Histoplasmosis, Pulmonary Tuberculosis, and Cytomegalovirus Disease in a Renal Transplant Recipient after Infection with SARS-CoV-2

INTRODUCTION: Infection with SARS-CoV-2 increases the risk of acute graft dysfunction (AGD) in renal transplant recipients (RTR), and the risk of concurrently presenting with opportunistic infections is also increased. There is no current consensus on the management of immunosuppression during SARS-...

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Autores principales: Mauricio, Carvallo-Venegas, Angélica, Fuentes-López Elsa, de Jesús, Andrade-Ortega Antonio, Rodrigo, Torres-Baranda José, Aldo, Carrasco-Carrizosa, Ignacio, Cerrillos-Gutierrez José, Jorge, Andrade-Sierra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9441404/
https://www.ncbi.nlm.nih.gov/pubmed/36071914
http://dx.doi.org/10.1155/2022/8042168
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author Mauricio, Carvallo-Venegas
Angélica, Fuentes-López Elsa
de Jesús, Andrade-Ortega Antonio
Rodrigo, Torres-Baranda José
Aldo, Carrasco-Carrizosa
Ignacio, Cerrillos-Gutierrez José
Jorge, Andrade-Sierra
author_facet Mauricio, Carvallo-Venegas
Angélica, Fuentes-López Elsa
de Jesús, Andrade-Ortega Antonio
Rodrigo, Torres-Baranda José
Aldo, Carrasco-Carrizosa
Ignacio, Cerrillos-Gutierrez José
Jorge, Andrade-Sierra
author_sort Mauricio, Carvallo-Venegas
collection PubMed
description INTRODUCTION: Infection with SARS-CoV-2 increases the risk of acute graft dysfunction (AGD) in renal transplant recipients (RTR), and the risk of concurrently presenting with opportunistic infections is also increased. There is no current consensus on the management of immunosuppression during SARS-CoV-2 infection in RTR. Case Presentation. A 35-year-old male RTR from a living related donor presented with SARS-CoV-2 infection (January 2021). Two months later, despite alterations to his immunosuppression regimen (tacrolimus (TAC) was reduced by 50%, and the mycophenolic acid (MMF) was suspended with the remission of symptoms), the patient presented with pulmonary tuberculosis, pneumonia due to respiratory syncytial virus (RSV), cytomegalovirus (CMV) pneumonitis, and histoplasmosis (HP). Management was initiated with antituberculosis medications, ganciclovir, antibiotics, and liposomal amphotericin B, and the immunosuppressants were suspended, yet the patient's evolution was catastrophic and the outcome fatal. CONCLUSION: We recommend that in RTR post-COVID-19, the immunosuppression regimen should be gradually reinstated along with strict vigilance in observing for highly prevalent coinfections (TB, HP, and CMV).
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spelling pubmed-94414042022-09-06 Disseminated Histoplasmosis, Pulmonary Tuberculosis, and Cytomegalovirus Disease in a Renal Transplant Recipient after Infection with SARS-CoV-2 Mauricio, Carvallo-Venegas Angélica, Fuentes-López Elsa de Jesús, Andrade-Ortega Antonio Rodrigo, Torres-Baranda José Aldo, Carrasco-Carrizosa Ignacio, Cerrillos-Gutierrez José Jorge, Andrade-Sierra Case Rep Transplant Case Report INTRODUCTION: Infection with SARS-CoV-2 increases the risk of acute graft dysfunction (AGD) in renal transplant recipients (RTR), and the risk of concurrently presenting with opportunistic infections is also increased. There is no current consensus on the management of immunosuppression during SARS-CoV-2 infection in RTR. Case Presentation. A 35-year-old male RTR from a living related donor presented with SARS-CoV-2 infection (January 2021). Two months later, despite alterations to his immunosuppression regimen (tacrolimus (TAC) was reduced by 50%, and the mycophenolic acid (MMF) was suspended with the remission of symptoms), the patient presented with pulmonary tuberculosis, pneumonia due to respiratory syncytial virus (RSV), cytomegalovirus (CMV) pneumonitis, and histoplasmosis (HP). Management was initiated with antituberculosis medications, ganciclovir, antibiotics, and liposomal amphotericin B, and the immunosuppressants were suspended, yet the patient's evolution was catastrophic and the outcome fatal. CONCLUSION: We recommend that in RTR post-COVID-19, the immunosuppression regimen should be gradually reinstated along with strict vigilance in observing for highly prevalent coinfections (TB, HP, and CMV). Hindawi 2022-08-28 /pmc/articles/PMC9441404/ /pubmed/36071914 http://dx.doi.org/10.1155/2022/8042168 Text en Copyright © 2022 Carvallo-Venegas Mauricio et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Mauricio, Carvallo-Venegas
Angélica, Fuentes-López Elsa
de Jesús, Andrade-Ortega Antonio
Rodrigo, Torres-Baranda José
Aldo, Carrasco-Carrizosa
Ignacio, Cerrillos-Gutierrez José
Jorge, Andrade-Sierra
Disseminated Histoplasmosis, Pulmonary Tuberculosis, and Cytomegalovirus Disease in a Renal Transplant Recipient after Infection with SARS-CoV-2
title Disseminated Histoplasmosis, Pulmonary Tuberculosis, and Cytomegalovirus Disease in a Renal Transplant Recipient after Infection with SARS-CoV-2
title_full Disseminated Histoplasmosis, Pulmonary Tuberculosis, and Cytomegalovirus Disease in a Renal Transplant Recipient after Infection with SARS-CoV-2
title_fullStr Disseminated Histoplasmosis, Pulmonary Tuberculosis, and Cytomegalovirus Disease in a Renal Transplant Recipient after Infection with SARS-CoV-2
title_full_unstemmed Disseminated Histoplasmosis, Pulmonary Tuberculosis, and Cytomegalovirus Disease in a Renal Transplant Recipient after Infection with SARS-CoV-2
title_short Disseminated Histoplasmosis, Pulmonary Tuberculosis, and Cytomegalovirus Disease in a Renal Transplant Recipient after Infection with SARS-CoV-2
title_sort disseminated histoplasmosis, pulmonary tuberculosis, and cytomegalovirus disease in a renal transplant recipient after infection with sars-cov-2
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9441404/
https://www.ncbi.nlm.nih.gov/pubmed/36071914
http://dx.doi.org/10.1155/2022/8042168
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