Acute lobar nephronia in a renal allograft: a case report and literature review
Journal
Transplantation proceedings
Journal Volume
40
Journal Issue
5
Pages
1737
Date Issued
2008-06
Author(s)
Abstract
We report a diabetic renal transplant recipient who presented with fever and right lower quadrant abdominal pain. Acute appendicitis was considered initially and she underwent emergent appendectomy. However, persistent symptoms postoperatively made us perform an imaging study to identify the problems. Abdominal and pelvic computed tomography disclosed several focal wedge-shaped lesions of low attenuation in the renal allograft. Acute lobar nephronia was successfully managed with parenteral antibiotics. The patient recovered without any sequela. A renal allograft in the right iliac fossa complicates the diagnosis among acute renal infection, malignancy, acute rejection, and even acute appendicitis. Biopsy of the renal allograft is sometimes needed due to clinically ambiguous imaging results. In this report, we not only detail the clinical course of such a rare case, but also review the previous 3 cases of acute lobar nephronia in renal allografts in the literature.
Subjects
FOCAL BACTERIAL NEPHRITIS; TRANSPLANT RECIPIENT; ACUTE APPENDICITIS; KIDNEY
SDGs
Other Subjects
cyclosporin A; mycophenolic acid 2 morpholinoethyl ester; piperacillin plus tazobactam; abdominal pain; acute appendicitis; adult; antibiotic therapy; article; bacterial infection; case report; computer assisted tomography; diabetic nephropathy; differential diagnosis; female; fever; graft infection; human; kidney allograft; kidney cancer; kidney graft rejection; kidney infection; priority journal; Aged; Appendectomy; Appendicitis; Diabetic Nephropathies; Female; Humans; Image Processing, Computer-Assisted; Kidney; Kidney Failure, Chronic; Kidney Transplantation; Tomography, X-Ray Computed; Transplantation, Homologous
Publisher
ELSEVIER SCIENCE INC
Type
journal article