Abstract

TORRES SERRANO, Rodolfo Eduardo et al. Cryptococcus neoformans co-infection in a kidney transplant patient with COVID-19. Rev. colom. nefrol. [online]. 2021, vol.8, n.2, e702.  Epub Jan 01, 2022. ISSN 2500-5006.  https://doi.org/10.22265/acnef.8.2.521.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the disease COVID-19, represents one of the most deleterious health emergencies of the last two decades; of which there are still innumerable unknowns about the course and handling of atypical presentations. Therefore, it is important to publish clinical cases of interest in a special population, such as kidney transplant recipients, who may have a greater risk of contracting the disease due to their immunosuppression and frequent contact with the medical care system.

Co-infection with other respiratory viruses is not uncommon in the transplanted population with COVID-19, and the association with opportunistic germs such as Mycobacteria, Cytomegalovirus, Pneumocystis jirovecii and fungi, such as Cryptococcus neoformans, is unknown, yet it is possible that this association could worsen the severity of the systemic and pulmonary involvement.

We present the case of a 45-year-old deceased-donor kidney transplant recipient man who was admitted to the emergency service; he presented acute respiratory difficulty syndrome (ARDS) and ventilatory failure due to infection by SARS-CoV-2. It was also confirmed that he had systemic infection by Cryptococcus neoformans without compromise of the central nervous system. It was necessary to use invasive mechanical ventilation, glucocorticoid, liposomal amphotericin B; he died 12 days after admission.

Keywords : coronavirus infections; SARS-CoV-2; Cryptococcus neoformans; kidney transplantation; immune tolerance..

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