Opportunistic Infections in Late Kidney Transplantation with Death Outcome: Case Report

Cytomegalovirus (CMV) and Pneumocystis jirovecii fungus are the main opportunistic microorganisms that affect transplanted individuals. Immunosuppressive drugs administered to prevent organ rejection leave immune system vulnerable these infections. The present report is about a kidney patient using immunosuppressants who was diagnosed with cytomegalovirus pneumocystosis requiring admission intensive care unit (ICU). Female patient, 57 years old, three ago, comorbidities, such as systemic arterial hypertension, hypertriglyceridemia type 2 diabetes mellitus. She admitted hospital in January 2020 history of diarrhea, cough, malaise weight loss seven kg month. made continuous use tacrolimus® mycophenolate sodium (MFS). After five days hospitalization, she transferred ICU due refractory worsening renal function respiratory pattern, mechanical ventilation. Chest tomography showed changes led diagnostic hypothesis CMV pneumonia or jirovecii. Treatment Ganciclovir® Bactrim® started. bronchial lavage polymerase chain reaction test confirmed infectious condition for Despite drug therapy instituted, there no improvement condition. started general progressive clinical picture graft function, failure, metabolic acidosis, hemodynamic instability severe distributive shock, evolving death. In report, it observed after late transplantation fragility caused by contributed development infection Adjusting doses individual needs can be an important measure maintaining proper consequently avoiding infections death outcomes.