Invasive fungal infections in renal transplant recipients: about 11 cases

Abstract

Invasive fungal infections are a major complication and an important cause of morbidity and mortality among solid organ transplant recipients. Their diagnosis is difficult and their prognosis is often pejorative.

Objective: The aim of this study was to report the cases of invasive fungal infections in renal transplant recipients in Habib Bourguiba Sfax university hospital and to identify the main fungal agents.

Materials and methods: It is a retrospective study of invasive fungal infections in renal transplant recipient reported in our hospital from January 1995 to February 2013.

Results: Invasive fungal infections were diagnosed in 11 cases (3.4%) among 321 renal transplant recipients. These infections included four cases of pneumocystosis, two cases of candidiasis, two cases of aspergillosis, two cases of cryptococcosis and one case of mucormycosis. There were six men and five women. The mean age was 37 years. The infection was late in 63% of cases (>3 months after transplantation). The prolonged corticosteroid and immunosuppressive therapy were the main risk factors (100%) followed by renal failure (45%), graft rejection (45%), broad spectrum antibiotics (45%), CMV infection (36%), neutropenia (36%) and dialysis (18%). The evolution under treatment was favourable only in two cases (18%).

Conclusion: Invasive fungal infections are not common among kidney transplant recipients. However, they remain an important cause of morbidity and mortality in this group of patients. Prevention, early diagnosis and appropriate management are necessary to improve prognosis and reduce mortality rate.

Keywords: Aspergillose; Aspergillosis; Candidiasis; Candidose; Cryptococcose; Cryptococcosis; Greffe rénale; Invasive mycosis; Mucormycose; Mucormycosis; Mycoses invasives; Pneumocystose; Pneumocystosis; Renal transplantation; Sfax; Tunisia; Tunisie.