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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Fungal infections account for 5–20% of post-renal transplant infections and cause 25–50% of related morbidity and mortality. Immunosuppression increase susceptibility to opportunistic fungi like Cryptococcus neoformans, Candida species, and Histoplasma capsulatum. These infections often present atypically and involve unusual sites such as skin, bone or vocal cords, complicating diagnosis. Emerging antifungal resistance further challenges treatment. This case series from a tertiary center in Bangalore highlights four renal transplant recipients with rare fungal infections with atypical presbeto raise awareness and improve early diagnosis.
We retrospectively studied four renal transplant patients with atypical fungal infections from 2016–2023 at Apollo Hospital, Bangalore. Inclusion required biopsy or culture-confirmed fungal infection at uncommon sites. Data included demographics, immunosuppression, clinical features, diagnostics (special stains, cultures, imaging), treatment, and outcomes. Standard immunosuppression comprised basiliximab or ATG induction and maintenance with calcineurin inhibitors, antimetabolites, and steroids. Follow-up monitored clinical progress and graft function.
Case 1: A 54-year-old man presented 3 months post-transplant with fever and cough. Imaging showed right lower lobe consolidation with cavities. Lung biopsy revealed Histoplasma capsulatum. He received liposomal amphoteric in B followed by itraconazole with full recovery and stable graft.
Case 2: A 53-year-old woman had erythematous subcutaneous nodules. Biopsy and culture showed Candida glabrata, resistant to amphotericin B but sensitive to echinocandins and posaconazole. Treatment with micafungin and posaconazole resolved lesions, preserving graft function.
Case 3: A 70-year-old man, 12 years post-transplant, developed scalp swelling and hoarseness. MRI revealed parietal bone osteomyelitis. Biopsies confirmed Cryptococcus neoformans. Treated with amphotericin B, flucytosine, and fluconazole, symptoms improved without CNS spread.
Case 4: A 34-year-old man developed painless nodular skin lesions 2 months post-transplant. Skin biopsy confirmed Cryptococcus neoformans. Liposomal amphotericin B and fluconazole cleared lesions, preserving graft function.
These cases highlight diverse fungal infections with atypical presentations post-transplant. Histoplasmosis, though underreported in India, must be considered in pulmonary infiltrates mimicking tuberculosis. Candida glabrata cutaneous infections are rare and pose therapeutic challenges due to resistance, underscoring the importance of susceptibility testing. Cryptococcosis usually presents as meningitis or pulmonary disease; here, uncommon osseous and cutaneous manifestations occurred without CNS involvement. Early biopsy and fungal identification enable timely, targeted treatment and graft preservation.
Atypical fungal infections in renal transplant recipients demand high suspicion and early diagnosis. Tissue biopsy and culture with susceptibility testing guide effective antifungal therapy, improving outcomes and preserving grafts. Enhanced clinical awareness is vital for managing these rare presentations.
