A CASE OF RENAL TRANSPLANT RECIPIENT COMPLICATED WITH CRYPTOCOCCOSIS AND AMPHOTERICIN B INDUCED ACUTE TUBULAR NECROSIS

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  • Case of Renal Transplant Recipient Comp

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Abstract

An adult renal transplant recipient was complicated with cryptococcal lung granuloma and meningitis. Treatment with the antifungal agents, 5-fluorocytocin and clotrimazole had to be discontinued due to side effects. Whereas, the intrathecal administration of amphotericin B proved effective for meningitis but intravenously it induced acute tubular necrosis to the transplanted kidney. Inorder to cure the persistant fungal lung granulomas in renal transplant patients early surgical excision seems to be essential. C'est un cas adulte d'un transplante renal complique par la cryptococcose granulomateuse pulmonaire et meningique, qui a ete ulterieurement traitee avec succes par l'excision partielle d'un poumon. Traitement avec des agents anti-fongique, 5-fluorocytocine et clotrimazole, a ete force d'arreter a cause des effects secondaires nefasts. Alors, l'administration intra-thecale d'amphotericine B a ete trouvee efficase pour meningite, mais ensuite, puand elle a ete donne par la route intra-veneuse, elle a provoque necrose tubulaire aique du rein greffe. Pour obtenir la guerison du granulome pulmonaire fongueux persistant chez les transplantes renaux, une intervention chirurgicale precoce semble indispensable.

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