The Incidence and Management of Pulmonary Mycosis in Renal Allograft Patients

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Abstract
A retrospective analysis of 193 renal transplant recipients yielded 15 patients who developed pulmonary mycosis post-transplantation and one case in which mycotic lung infection existed at the time of transplant surgery. Agents responsible for infection included Nocardia asteroides in 8 cases, Aspergillus flavus in 5 cases, Cryptococcus neoformans in 4 patients and Candida albicans in 2 cases. Two cases had mixed mycotic infections. Ten patients died, of which 7 had diagnosis established antemortem. Two cases had diagnosis established by thoracotomy and 1 case by transtracheal aspiration. Problems in establishing accurate diagnosis are discussed with emphasis placed on the need for more frequent use of transtracheal aspiration and thoracotomy for precise diagnosis.