Late Onset of Renal Abscess Mimicking Malignancy in a Retransplant Female

Abstract

A 67-year-old female, a retransplanted kidney recipient from her daughter in 2012 on triple immunosuppressants with chronic kidney disease Stage IIIb, presented with fever, loss of appetite, right iliac fossa pain, and tiredness for 2 weeks. Her first kidney transplant was done in 1998 with external iliac vessels being used for the anastomosis. She is a diabetic, hypertensive, hypothyroid, and post-COVID status who had previously recurrent urinary tract infections since 2022. She was found to have a right iliac fossa mass at the site of the first kidney transplant, which was tender. Imaging including ultrasound and positron emission tomography/computed tomography showed a metabolically active right iliac fossa mass infiltrating the anterior abdominal wall. Surgery revealed a mass and on histopathology revealed a renal abscess which grew Candida ciferrii and tissue culture grew Enterobacter cloacae. She was treated with injection levofloxacin and tablet posaconazole and she recovered. This patient was presented for the interesting finding of coinfection in the late posttransplant period.

Keywords

• coinfection with candida ciferrii and enterobacter cloacae in the abscess
• renal transplantation
• transplant nephrectomy