دورية أكاديمية

LARGE SUBCLINICAL ABSCESS OF A FORGOTTEN FAILED RENAL ALLOGRAFT

التفاصيل البيبلوغرافية
العنوان: LARGE SUBCLINICAL ABSCESS OF A FORGOTTEN FAILED RENAL ALLOGRAFT
المؤلفون: Kochhar, Parul, Ng Sueng, Luis F
المصدر: Internal Medicine Meeting Abstracts
بيانات النشر: Henry Ford Health Scholarly Commons
سنة النشر: 2023
المجموعة: Henry Ford Health System Scholarly Commons
مصطلحات موضوعية: amoxicillin plus clavulanic acid, endogenous compound, ertapenem, hemoglobin, abdomen, abscess, Actinomyces, adult, anemia, antibiotic therapy, asymptomatic bacteriuria, bacterial infection, bacterium culture, blood cell count, bone cancer, cancer patient, cancer recurrence, cancer surgery, cardiovascular disease, catheterization, community acquired pneumonia, complication, computer assisted tomography, conference abstract, drain, drug therapy, end stage renal disease, female, graft failure, human
الوصف: CASE: 39 year old female with a history of left nephrectomy in 2009, end-stage renal disease due to obstructive uropathy from neurogenic bladder, status post kidney transplant in 2016 with subsequent failure in 2020. She started peritoneal dialysis that year. She had residual urine production, for which she used intermittent straight catheterization. She was admitted for severe symptomatic anemia. Vitals were within normal limits. The examination was remarkable for subtle pain in the right lower quadrant. Complete blood count revealed a white count of 14.2 and hemoglobin of 6.0 mg/dL. Incidentally, the nursing staff noted cloudy urine with a very dense consistency during her straight catheterization. Dipstick urinalysis was unable to be fully processed due to the dense consistency of her urine but showed 149 RBCs, 182 WBCs, and many bacteria. Computed Tomography Abdomen showed a 7 cm large gas and fluid collection with no normal identifiable renal parenchyma consistent with necrosis of her kidney allograft. Abscess culture grew Actinomyces species and she was started on Ertapenem. The transplant surgery team was consulted but did not recommend transplantectomy due to poor surgical candidacy. A percutaneous drain was placed to achieve source control. She was eventually discharged with long-term oral antibiotic therapy with Augmentin. IMPACT/DISCUSSION: 1 in 5 patients with renal transplantation will have allografts that fail in 5 years, and more than one in two will have graft failure by 10 years. Potential complications of failed allografts include infections, malignancy, bone disease, and cardiovascular disease. Among these, infections remain the leading cause of complications following a kidney transplant. These can occur early post-transplant, during peak immunosuppression, and late onset. The latter occurs 6-12 months following transplant and includes community-acquired pneumonia, upper respiratory infections, and urinary infections, which are by far the most common. In patients with urinary infections, the ...
نوع الوثيقة: text
اللغة: unknown
العلاقة: https://scholarlycommons.henryford.com/internalmedicine_mtgabstracts/157Test; http://sfxhosted.exlibrisgroup.com/hfhs?sid=EMBASE&issn=15251497&id=doi:10.1007%2Fs11606-023-08226-z&atitle=ARGE+SUBCLINICAL+ABSCESS+OF+A+FORGOTTEN+FAILED+RENAL+ALLOGRAFT&stitle=J.+Gen.+Intern.+Med.&title=Journal+of+General+Internal+Medicine&volume=38&issue=&spage=S591&epage=&aulast=Kochhar&aufirst=Parul&auinit=P.&aufull=Kochhar+P.&coden=&isbn=&pages=S591-&date=2023&auinit1=P&auinitmTest=
الإتاحة: https://scholarlycommons.henryford.com/internalmedicine_mtgabstracts/157Test
رقم الانضمام: edsbas.E46763BA
قاعدة البيانات: BASE