Atypical Infections in Immunocompromised Renal Patients: A Case Series

A BSTRACT Opportunistic infections frequently manifest in patients undergoing immunosuppressive therapy. This case series outlines three cases of atypical/unique infections in individuals with renal diseases undergoing immunosuppression. The first patient, who was receiving immunosuppression for a renal transplant, was diagnosed with extrapulmonary tuberculosis (TB), specifically TB of the spine and a cold abscess in the right thigh, which was addressed through cold abscess drainage and the initiation of modified anti-TB therapy. The second patient was diagnosed with disseminated strongyloides infection in the background of immunosuppression for immunoglobin A (IgA) nephropathy, experiencing complications such as pneumonia, subacute intestinal obstruction and Gram-negative meningitis, all appropriately managed. The third case, presenting with pulmonary symptoms and renal transplant graft dysfunction, was diagnosed with pulmonary histoplasmosis through histopathological examination of an endobronchial biopsy specimen. Treatment involved anti-fungal medications and a reduction in immunosuppression. This case series highlights the importance of considering atypical infections in immunocompromised patients with renal disease. Vigilant monitoring for signs of unusual or opportunistic infections is vital, given the intricate nature of diagnosis and treatment in individuals with compromised immune systems.