Praveen Kumar Kolla
Narayana Medical College, India
Praveen Kumar Kolla has completed his graduation in Medicine from Kurnool Medical college , Kurnool and post graduation in Internal Medicine from Manipal Academy of Higher Education . He was trained in Nephrology from Sri Ramachandra University, Chennai, India. He is the Professor and Head , Department of Nephrology, Narayana Medical College, Nellore. He has published more than 20 papers in reputed journals.
Introduction: Invasive fungal infections cause significant morbidity and mortality in renal transplant recipients. The opportunistic pathogens such as Candida, Aspergillus, Mucormycosis, Cryptococcus, Histoplasma,Coccidioides are known to infect the kidneys in predisposed individuals with serious complications. Recipients of solid organ transplants have 24-40% incidence of opportunistic fungal infections with a very high mortality of 70-100%. Objective: To report the spectrum of fungal infections in renal allograft recipients at Narayana medical college -Nellore , Andhra Pradesh, INDIA. Materials and Methods: 70 patients who underwent kidney transplantation between march 2010-feb 2016 were reviewed. Among these, 65 were live related and 5 were deceased donor transplants. Only 16 patients received induction therapy with either ATG or Basiliximab and all were on triple immunosuppression with Tacrolimus, MMF and Steroids. Patients who were diagnosed having fungal infections were included in our study. Diagnosis was based on clinical, radiological, culture and histopathological examination. Results: Out of 11 patients with various fungal infections 4 were found to have aspergillus, 2 were infected with Candida , 3 with Pneumocystis, 1 with mucor mycosis,1 with chromoblastomycosis. Of these 3 were in the form of cutaneous nodules, 7 were invasive fungal infections, One had aneurysm of graft renal artery. Inspite of appropriate antifungal therapy 4 of these patients with invasive fungal infection expired . Conclusion: The mortality of invasive fungal infections is still high in renal allograft recipients despite newer antifungal agents. Early detection of invasive fungal infections and prompt initiation of therapy are important in reducing mortality.