Aspergillosis in Four Renal Transplant Recipients

Abstract

Four patients who had recently received kidney transplants became infected with Aspergillus fumigatus while receiving immunosuppressive therapy. Three were shown to have invasive pulmonary mycotic disease, and one of these had documented dissemination. A fourth patient had respiratory symptoms and fever and was found to have mycelial forms consistent with A. fumigatus in his sputum, verified by cultures. All four were effectively treated with amphotericin B in low, widely spaced doses. Early diagnosis was apparently the key to successful management of the invasive Aspergillus fumigatus infection in these patients. Discovery of mycelial forms in fresh preparations of sputa or bronchial washings is a valuable clue to active infections. Securing tissue by biopsy is warranted in those patients who develop a pulmonary infiltrate or cavity that is not otherwise causally explained.