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A 48-year-old man with diabetes mellitus underwent pancreas–kidney transplantation for end-stage renal disease. One month later, he was treated for rejection, and computed tomography of the chest showed no pulmonary infiltrates. Nine months after transplantation, cryptococcal meningitis developed. He received intravenous amphotericin B–lipid complex, and long-term therapy with oral fluconazole was begun. The serum cryptococcal antigen titer was 1:512 and decreased to undetectable levels over a period of five years. Six years after transplantation, progressive renal-allograft failure developed. A chest radiograph showed multiple nodules confined to the left lung. The patient had no fever and no pulmonary symptoms. Computed tomography . . . [Full Text of this Article] |
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