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Cryptococcal Pyelonephritis and Disseminated Cryptococcosis in a Renal Transplant Recipient
Richard N. Hellman, MD;
James Hinrichs, MD;
Gregorio Sicard, MD;
Richard Hoover, MD;
Paul Golden, MD;
Phillip Hoffsten, MD
Arch Intern Med. 1981;141(1):128-130.
Abstract
Symptomatic cryptococcal pyelonephritis, meningitis, and disseminated cryptococcosis are described in a renal cadaver transplant recipient who subsequently died of Klebsiella pneumoniae sepsis. The presence of cryptococcuria and a subsequent positive CSF India ink stain led to the initial diagnosis of disseminated cryptococcosis. Therapy with 0.511 g of amphotericin B and 112.5 g of flucytosine for four weeks did not eradicate Cryptococcus from the kidney and was associated with hepatotoxicity. The importance of urinary examination and culture for C neoformans is emphasized. Cryptococcal pyelonephritis should be considered in the differential diagnosis of allograft rejection in the renal transplant patient.
(Arch Intern Med 141:128-130, 1981)
Author Affiliations
From the Renal and Infectious Diseases Divisions, the Departments of Medicine (Drs Hellman, Hinrichs, Golden, and Hoffsten), Surgery (Dr Sicard), and Pathology (Dr Hoover), Washington University School of Medicine, St Louis. Dr Hellman is now at the Duluth Clinic Ltd, Duluth, Minn, and Dr Hoffsten is now at the Medical Associates Clinic, Pierre, SD.
Footnotes
Accepted for publication April 14, 1980.
Reprint requests to Department of Medicine, Division of Infectious Diseases, Barnes and Wohl Hospital, 660 S Euclid Ave, St Louis, MO 63110 (Dr Hinrichs).
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