{Reference Type}: Journal Article
{Title}: Brain abscess following kidney transplantation: A single centre observational study from North India.
{Author}: Singh V;Singh P;Dogra PM;Nair RK;Ghosh I;Sreenivasa S;
{Journal}: Med J Armed Forces India
{Volume}: 79
{Issue}: 6
{Year}: 2023 Nov-Dec
暂无{DOI}: 10.1016/j.mjafi.2023.09.004
{Abstract}: <B>UNASSIGNED: </B>Amongst the infections in kidney transplant recipients, brain abscess represents an uncommon life-threatening complication. Mortality continues to be high despite improvements in diagnostics and therapeutics.<BR><B>UNASSIGNED: </B>We conducted an observational study, describing the incidence, presentation, implicating pathogen, management and outcome of brain abscess following kidney transplantation at our centre.<BR><B>UNASSIGNED: </B>Amongst the 1492 patients who underwent kidney transplantation at our centre between June 1991 and January 2023 (cumulative follow-up: 4936 patient-years), five females and four males, developed brain abscesses. The incidence proportion (risk) is 0.6% with an incidence rate of 6.03 cases per 1000 patient years. The median duration from transplant to development of brain abscess was 5 weeks (range: 4 weeks to 9 years). The commonest presentation was a headache. A definitive microbiological diagnosis was established in eight out of nine patients. The commonest implicated organism was a dematiaceous fungus, Cladophialophora bantiana (3 patients, 33.3%). Despite the reduction in immunosuppression, surgical evacuation and optimal medical therapy, five (55.55%) patients succumbed to their illness.<BR><B>UNASSIGNED: </B>Brain abscesses following kidney transplantation is an uncommon, life-threatening condition. It usually occurs in the early post-transplant period and the presentation is often subtle. Unlike immunocompetent individuals, a fungus is the most common causative organism in those with solid organ transplants. The management includes a reduction in immunosuppression, early antimicrobial therapy, and surgical decompression.