Introduction:
Histoplasma capsulatum, the causative agent of histoplasmosis, is a dimorphic fungus that exists as a mold in the environment and transforms into a yeast form in human tissues. Histoplasma capsulatum thrives in damp soil enriched with organic material from bird and bat droppings. When the soil is disturbed, the spores become airborne and can be inhaled into the lungs. The spores can then convert to yeast form at body temperature, leading to infection. immunocompromised hosts have a propensity for severe infection and may present in varying ways inclusive of pulmonary, extrapulmonary and disseminated disease given their inability to contain the infection, with significant associated morbidity and mortality.
Methods:
A retrospective analysis of 15 patients who were diagnosedtohave histoplasma infection post renal transplantation from 2018 to 2023 in thedepartment of Nephrology at VPS lakeshore hospital.The presenting features, histological analysis,management strategies and prognosis have been were analyzed.
Results:
15 patients were diagnosed with histoplasma infection post renal transplant. 13 were males and the rest were females. Median time from transplant to diagnosis was 26months . Mean age of recipients is 52 years . Two patients were retransplant recipients.The induction agent given was mostly basiliximab 9, followed by Antithymocyte globulin-6. All patients received triple-maintenance immunosuppression. Varying presentation of histoplasma was noted, including pulmonary in the form of nodules, lymphadenopathy, extrapulmonary - skin, laryngeal, prostatic, anal papilloma and disseminated infection. All were treated with iv amphotericin B and itraconazole. Two patients succumbed to illness.
Conclusions:
In renal transplant recipients, histoplasma infection generally manifests with varying presentation. Histoplasma infection is to be considered differential in renal transplant recipients presenting with fatigue, lethargy, unexplained weight loss. Post- transplant patients have good outcomes with liposomal amphotericin B and itraconazole.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.