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NDT Advance Access originally published online on October 12, 2005
Nephrology Dialysis Transplantation 2005 20(12):2848-2850; doi:10.1093/ndt/gfi167
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Teaching Point
(Section Editor: A. Meyrier)

Acute respiratory infection in a renal transplant recipient

Anna Richards1, Jenny Ng Kam Chuen1, Clive Taylor2, Ralph Jackson1, Geoffrey Toms3 and David Kavanagh1

1 The Freeman Hospital, Newcastle upon Tyne, NE7 7DN, 2 Health Protection Agency, North East Laboratory, Newcastle upon Tyne, NE4 6BE, and 3 The School of Clinical Medical Sciences, University of Newcastle, Newcastle upon Tyne, NE2 4HH, UK

Corresponding and offprint requests to: Anna Richards, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8045, St Louis, MO 63110, USA. Email: anna.richards@ncl.ac.uk

Keywords: bronchoalveolar lavage; human metapneumovirus; immunocompromised; opportunistic infection; renal transplant; respiratory tract infection

The first 10% of the full text of this article appears below.



   Introduction
 
We report the case of a 43-year-old renal transplant recipient who required ventilatory support for acute respiratory tract infection. The differential diagnosis in immunocompromised individuals is extensive and requires prompt investigation.



   Case report
 
A 43-year-old male non-smoker with end stage kidney failure due to medullary cystic kidney disease received a 1:1:1 cadaveric renal allograft in 2001. The transplant initially functioned well, but 1 month after transplantation, his renal function worsened and a renal transplant biopsy showed mild cellular rejection. He was treated with methylprednisolone (500 mg/day for 3 days) and his renal function improved to a baseline creatinine of 160 µmol/l. He subsequently had a cytomegalovirus (CMV) seroconversion illness with diarrhoea and deterioration in renal function. This was successfully treated with ganciclovir.

For the next 3 years he experienced no medical problems and his . . . [Full Text of this Article]



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