Paper Title: A cross sectional study of pulmonary infections in renal allograft recipients in a tertiary care hospital in India

Author(s) - Vaibhav Shankar1, Deepak Rosha2, *Krittibus Samui3, Prasanta Kumar De4

 DOI: - 10.23958/isroj/vol03-i03/01


Abstract:

The pulmonary infection is a major cause of morbidity among renal transplant recipients. There is need for quick and thorough diagnostic evaluation for the diagnosis of the etiological agent.

Objectives of the Study - This is an observational cross-sectional study on pattern of pulmonary infections in renal transplant recipients.

Study design- Total 54 renal transplant recipients suspected of having pulmonary infection on initial screening were evaluated by clinical, radiological and laboratory parameters.

Salient Findings-

(1) Fever (74.1%) was the most common symptom followed by cough (61.1%) and (55.6%) dyspnoea;

(2) Computed tomography was found to be a better diagnostic modality than chest X-ray. Ground glass opacity was a common finding in all pneumocystis infection and nodules in aspergillosis and mucormycosis;

(3) Bronchoalveolar lavage fluid was found to provide a better specimen than sputum for microbiological diagnosis. Bronchoscopy and tissue diagnosis are the investigational modalities that provide the maximal yield of etiological agents;

(4) A bacterium was the single most common infectious agent followed by fungus, tuberculosis, virus, PCP, nocardia and strongloides (in decreasing order). Tuberculosis was the common single organism causing the pulmonary infection in our study. There has been a rise in the multiple infections, occurring simultaneously in the same patients;

(5) there was only one infection within one month of post-transplant. The incidence of infection gradually increased thereafter with a peak at the 6mnth to 2 years’ time period after which the incidence of infection again showed a decreasing trend.

Conclusion-There is rise in incidence of multiple infections in post renal transplant patients; so, search should not end on isolating single organisms. Computed tomography is much more helpful in diagnosis as compared to X- ray. Bronchoalveolar lavage should be done in such patients routinely and the use of other more invasive methods like biopsy should also be liberal.

Keywords: Transplant, Infection, Tomography, Bronchoscopy