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Week 5

III. Trimethoprim-Sulfamethoxazole (Bactrim) Dose Optimization in Pneumocystis jirovecii Pneumonia (PCP) Management: A Systematic Review
18
Feb
137

Please summarise this article. What is the level of evidence provided by this article? View / Download

Posted in: Post-transplant Long-term Complications , Week 5 ,
II. Drug Resistance in Pneumocystis jirovecii
18
Feb
124

Please summarise this article. What is the level of evidence provided by this article? View / Download

Posted in: Post-transplant Long-term Complications , Week 5 ,
I. Impact of Pneumocystis jirovecii pneumonia on kidney transplant outcome
18
Feb
168

Please summarise this article. What is the level of evidence provided by this article? View / Download

Posted in: Post-transplant Long-term Complications , Week 5 ,
5. A 48-year-old woman was admitted with epigastric pain and deterioration of kidney function 2 months after ABOi kidney transplantation. A routine infection screen and USS of her kidney were normal. USS of the liver and gall bladder was also reported normal. Anti-A IgG titre has risen from 1/8 to 1/512. CMV positive/CMV negative transplantation on Valganciclovir® 900 mg/daily. Kidney biopsy and C4d staining are shown below:
18
Feb
134

OGD and biopsy are shown below: Describe the finding. How do you manage the case?

Posted in: Post-transplant Long-term Complications , Week 5 ,
4. The picture below is for PCP (Pneumocystis pneumonia caused by Pneumocystis Jirovecii) diagnosed by lung biopsy
18
Feb
150

What are the modalities used in the diagnosis of this disease? What are their sensitivities and specificities? What is the place of lung biopsy in the diagnosis of PJP?

Posted in: Post-transplant Long-term Complications , Week 5 ,
3. A 39-year-old CKD 5 secondary to HIV associated nephropathy had a deceased donor kidney transplantation. CD4 count is 250/ml and receiving HAART. Currently she is on Tacrolimus-based triple immunosuppression. Her kidney function has improved and started to pass more urine. She presented with 2 weeks history of non-productive cough, low grade temperature (37.5 °C). She has dyspnoea on excretion (respiratory rate at rest is 20/min) but chest X-Ray reported normal. Clinically there were few physical findings only few scattered wheezes. Sat 100% on air and desaturates to 95% on exertion.
18
Feb
177

What is the differential diagnosis? How do you manage this case?

Posted in: Post-transplant Long-term Complications , Week 5 ,
2. A 61-year-old CKD 5 secondary to diabetic nephropathy had a deceased donor kidney transplantation. Currently she is on Tacrolimus-based triple immunosuppression. Her kidney function has improved and started to pass more urine. On day 11 she developed dry cough, low grade temperature (37.8 °C). Clinically there were very few physical findings only of few scattered crepes. She has dyspnoea (respiratory rate is 38/min) but chest X-Ray showed bilateral perihilar infiltrates (see below). CT chest showed ground glass appearance. Blood gas showed PaO2 of 8 kPa and picture of compensated respiratory alkalosis.
18
Feb
194

What is the differential diagnosis? How do you manage this case?

Posted in: Post-transplant Long-term Complications , Week 5 ,
1. A 65-year-old man was admitted with a fever (38 °C) and non-productive (dry) cough 4 months after cadaveric transplantation. CMV negative to CMV positive recipient. Oxygen saturation on air was reported at 89%. CXR is shown below:
18
Feb
259

What is your differential diagnosis? How do you manage this case?

Posted in: Post-transplant Long-term Complications , Week 5 ,
Pneumocystis Pneumonia in SOT – Discussion
18
Feb
40
Posted in: Post-transplant Long-term Complications , Week 5 ,
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