Post-Renal Transplant Miliary Mottling: Not Always Tuberculosis.

Autor: Yashwanth Raj T; Department of Nephrology and Microbiology, Government Stanley Medical College, The TN Dr. MGR Medical University, Chennai, Tamil Nadu, India., Vairakkani R; Department of Nephrology and Microbiology, Government Stanley Medical College, The TN Dr. MGR Medical University, Chennai, Tamil Nadu, India., Harshavardhan TS; Department of Nephrology and Microbiology, Government Stanley Medical College, The TN Dr. MGR Medical University, Chennai, Tamil Nadu, India., Srinivasaprasad ND; Department of Nephrology and Microbiology, Government Stanley Medical College, The TN Dr. MGR Medical University, Chennai, Tamil Nadu, India., Dilli Rani V; Department of Nephrology and Microbiology, Government Stanley Medical College, The TN Dr. MGR Medical University, Chennai, Tamil Nadu, India., Edwin Fernando M; Department of Nephrology and Microbiology, Government Stanley Medical College, The TN Dr. MGR Medical University, Chennai, Tamil Nadu, India.
Jazyk: angličtina
Zdroj: Indian journal of nephrology [Indian J Nephrol] 2020 Mar-Apr; Vol. 30 (2), pp. 121-124. Date of Electronic Publication: 2020 Jan 03.
DOI: 10.4103/ijn.IJN_141_19
Abstrakt: A 28-year-old male, 3 years post renal transplant with stable graft function, presented with vomiting for 2 days. He had graft dysfunction and graft biopsy done revealed acute cell - mediated rejection BANFF-IA. After receiving glucocorticoids for rejection, he developed severe enterocolitis and impending respiratory failure. Chest X-ray and computed tomography of the chest revealed miliary mottling. Evaluation showed presence of filariform larvae of Strongyloides stercoralis in the stool and sputum. A diagnosis of Strongyloides Hyperinfection Syndrome (SHS) was made. After a prolonged course of treatment with noninvasive ventilation, broad-spectrum antimicrobials, parenteral ivermectin and oral albendazole therapy, he eventually recovered. This case report is to highlight that Strongyloides Hyperinfection Syndrome should also be considered in the differential in any immunocompromised patient presenting with miliary mottling in imaging.
Competing Interests: There are no conflicts of interest.
(Copyright: © 2020 Indian Journal of Nephrology.)
Databáze: MEDLINE
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