Renal aspergillosis after liver transplantation: clinical and imaging manifestations in two cases

World J Gastroenterol. 2014 Dec 28;20(48):18495-502. doi: 10.3748/wjg.v20.i48.18495.

Abstract

Renal aspergillosis (RAsp) is a rare complication in liver transplant (LT) recipients. Here we report RAsp in two LT recipients. In both patients, RAsp occurred more than 90 d after allogenetic orthotropic LT, and all the clinical findings were unspecific. RAsp involved unilateral kidney in Case one and bilateral kidneys in Case two. Both computed tomography (CT) and magnetic resonance imaging (MRI) revealed renal abscesses, with progressively enhanced walls and separations and unenhanced alveolate areas after contrast agent administration. On unenhanced CT images they showed inhomogeneous hypo-attenuation. On fat-suppressed T2-weighted images (T2WIs), the walls and separations of the abscesses showed slightly low signal intensity and the central parts of the lesions showed slightly high signal intensity. Both on CT and MRI, there were some hints of renal infarction or chronic ischemia. Both cases were treated by radical nephrectomy followed by adjuvant antifungal treatment. They all recovered well.

Keywords: Aspergillus infection; Computed tomography; Kidney; Liver transplantation; Magnetic resonance imaging; Treatment.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Abscess / diagnosis
  • Abscess / microbiology*
  • Abscess / therapy
  • Antifungal Agents / therapeutic use
  • Aspergillosis / diagnosis
  • Aspergillosis / microbiology*
  • Aspergillosis / therapy
  • Biopsy
  • Humans
  • Kidney Diseases / diagnosis
  • Kidney Diseases / microbiology*
  • Kidney Diseases / therapy
  • Liver Transplantation / adverse effects*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Nephrectomy
  • Predictive Value of Tests
  • Reoperation
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Antifungal Agents