Case 35-2009: A 60-year-old male renal-transplant recipient with renal insufficiency, diabetic ketoacidosis, and mental-status changes

New England Journal of Medicine

Volumn 361, Issue 20, 2009, Pages

  Baden, Lindsey R ^a,c   Digumarthy, Subba R ^b,c   Guimaraes, Alexander S R ^b,c   Branda, John A ^b,c  

^a BRIGHAM AND WOMEN S HOSPITAL   (United States)

^b MASSACHUSETTS GENERAL HOSPITAL   (United States)

^c HARVARD MEDICAL SCHOOL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

AZTREONAM; CEFEPIME; CLOPIDOGREL; CORTICOSTEROID; DIURETIC AGENT; DOPAMINE; INSULIN; LEVOFLOXACIN; METRONIDAZOLE; NORADRENALIN; VANCOMYCIN;

ADULT; ANAMNESIS; ARTICLE; CASE REPORT; CLINICAL FEATURE; COCCIDIOIDES; COCCIDIOIDOMYCOSIS; DIABETES MELLITUS; DIABETIC KETOACIDOSIS; DIARRHEA; DIFFERENTIAL DIAGNOSIS; FLUID THERAPY; GRAFT INFECTION; HUMAN; HYPOTENSION; KIDNEY FAILURE; KIDNEY GRAFT; MALE; MENTAL DISEASE; OXYGEN THERAPY; PHYSICAL EXAMINATION; PRIORITY JOURNAL; SERODIAGNOSIS; CLINICAL OBSERVATION; CLINICAL STUDY; COMPUTER ASSISTED TOMOGRAPHY; CONFUSION; DIAGNOSIS; FATALITY; IMMUNOCOMPROMISED PATIENT; KIDNEY; KIDNEY TRANSPLANTATION; LUNG; LUNG MYCOSIS; MIDDLE AGED; NECROSIS; NEEDLE BIOPSY; OPPORTUNISTIC INFECTION; PATHOLOGY; RADIOGRAPHY;

BIOPSY, NEEDLE; COCCIDIOIDOMYCOSIS; CONFUSION; DIABETIC KETOACIDOSIS; DIAGNOSIS, DIFFERENTIAL; FATAL OUTCOME; HUMANS; IMMUNOCOMPROMISED HOST; KIDNEY; KIDNEY TRANSPLANTATION; LUNG; LUNG DISEASES, FUNGAL; MALE; MIDDLE AGED; NECROSIS; OPPORTUNISTIC INFECTIONS; RENAL INSUFFICIENCY; TOMOGRAPHY, X-RAY COMPUTED;

EID: 70449669289     PISSN: 00284793     EISSN: 15334406     Source Type: Journal    
DOI: 10.1056/NEJMcpc0900645     Document Type: Article

References (23)

1. Fishman JA. Infection in solid-organ transplant recipients. N Engl J Med 2007; 357:2601-2614
2. Fishman JA, Rubin RH. Infection in organ-transplant recipients. N Engl J Med 1998;338:1741-1751
3. Baden LR, Rubin RH. The sentinel chicken revisited: the impact of West Nile virus infection on transplant patients. Transplantation 2004;77:356-357
4. Blair JE, Coakley B, Santelli AC, Hentz JG, Wengenack NL. Serologic testing for symptomatic coccidioidomycosis in immunocompetent and immunosuppressed hosts. Mycopathologia 2006;162:317-324 (Pubitemid 44819314)
5. Rodríguez M, Chou S, Fisher DC, De Girolami U, Amato AA, Marty FM. Lyme meningoradiculitis and myositis after allogeneic hematopoietic stem cell transplantation. Clin Infect Dis 2005;41(12):e112-e114.
6. Marty FM, Koo S. Role of (1→3)-beta- D-glucan in the diagnosis of invasive aspergillosis. Med Mycol 2009;47:Suppl 1: S233-S240.
7. Kuberski T, Myers R, Wheat LJ, et al. Diagnosis of coccidioidomycosis by antigen detection using cross-reaction with a Histoplasma antigen. Clin Infect Dis 2007; 44(5):e50-e54.
8. Assi MA, Binnicker MJ, Wengenack NL, Deziel PJ, Badley AD. Disseminated coccidioidomycosis in a liver transplant recipient with negative serology: use of polymerase chain reaction. Liver Transpl 2006;12:1290-1292
9. Stevens DA. Coccidioidomycosis. N Engl J Med 1995;332:1077-1082
10. Fisher MC, Koenig GL, White TJ, et al. Biogeographic range expansion into South America by Coccidioides immitis mirrors New World patterns of human migration. Proc Natl Acad Sci U S A 2001;98:4558-4562
11. Barker BM, Jewell KA, Kroken S, Or- bach MJ. The population biology of coccidioides: epidemiologic implications for disease outbreaks. Ann N Y Acad Sci 2007; 1111:147-163
12. Jewell K, Cheshier R, Cage GD. Genetic diversity among clinical Coccidioides spp. isolates in Arizona. Med Mycol 2008;46: 449-455
13. Ramani R, Chaturvedi V. Antifungal susceptibility profiles of Coccidioides immitis and Coccidioides posadasii from endemic and non-endemic areas. Mycopathologia 2007;163:315-319 (Pubitemid 46919105)
14. Saubolle MA. Laboratory aspects in the diagnosis of coccidioidomycosis. Ann N Y Acad Sci 2007;1111:301-314
15. Pappagianis D, Zimmer BL. Serology of coccidioidomycosis. Clin Microbiol Rev 1990;3:247-268
16. Blair JE, Balan V, Douglas DD, Hentz JG. Incidence and prevalence of coccidioidomycosis in patients with end-stage liver disease. Liver Transpl 2003;9:843-850 (Pubitemid 36974952)
17. Blair JE, Douglas DD. Coccidioidomy- cosis in liver transplant recipients relocating to an endemic area. Dig Dis Sci 2004;49:1981-1985
18. Blair JE. State-of-the-art treatment of coccidioidomycosis: skin and soft-tissue infections. Ann N Y Acad Sci 2007;1111: 411-421 (Pubitemid 47573014)
19. Galgiani JN, Ampel NM, Blair JE, et al. Coccidioidomycosis. Clin Infect Dis 2005; 41:1217-1223
20. Mertz LE, Blair JE. Coccidioidomyco- sis in rheumatology patients: incidence and potential risk factors. Ann N Y Acad Sci 2007;1111:343-357 (Pubitemid 47573025)
21. Winthrop KL, Yamashita S, Beekmann SE, Polgreen PM. Mycobacterial and other serious infections in patients receiving anti-tumor necrosis factor and other newly approved biologic therapies: case finding through the Emerging Infections Network. Clin Infect Dis 2008;46:1738-1740 (Pubitemid 351706773)
22. Keane J, Gershon S, Wise RP, et al. Tuberculosis associated with infliximab, a tumor necrosis factor alpha-neutralizing agent. N Engl J Med 2001;345:1098-1104 (Pubitemid 34940777)
23. FDA requires stronger fungal infec- tion warning for TNF blockers. (Accessed October 19, 2009, at http://www.fda.gov/ forconsumers/consumerupdates/ ucm107878.htm.)