A case of late-onset organizing pneumonia following COVID-19 infection in a post-kidney transplant patient.

Publication date: Feb 17, 2024

A 50-year-old man who had undergone a living-donor kidney transplant 12 years prior for chronic renal failure due to autosomal dominant polycystic kidney disease contracted coronavirus disease 19 (COVID-19). He had a positive antigen test, mild symptoms, sore throat, and fever of 37. 9 ℃. The patient was treated with molnupiravir for 5 days, and the symptoms disappeared 5 days after onset. However, 10 days after onset, he developed a fever of approximately 37 ℃ and a non-productive cough; 27 days after onset, the patient was hospitalized for anorexia and a worsening respiratory condition. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigen test results on admission were negative, and no antiviral medications were administered against SARS-CoV-2. Computed tomography revealed extensive ground-glass opacities in both lung fields. The patient was treated with steroid pulse therapy, ceftriaxone, atovaquone, azithromycin, and respiratory management using a high-flow nasal cannula. The combined therapies were successful, and the patient was managed with a nasal oxygen cannula after 3 days. Oxygen administration was discontinued after 6 days of hospitalization, and the patient was discharged after 14 days. Based on the laboratory findings, bacterial, interstitial, and Pneumocystis pneumonia were unlikely. The success of the steroid pulse therapy suggested that respiratory failure was caused by pneumonia due to the immune response after COVID-19 infection.

Concepts Keywords
10days Kidney transplantation
Hospitalization Post-COVID-19
Kidney SARS-CoV-2
Pneumonia
Tomography

Semantics

Type Source Name
disease MESH organizing pneumonia
disease MESH COVID-19
disease MESH infection
disease MESH chronic renal failure
disease MESH sore throat
disease MESH anorexia
disease VO Severe acute respiratory syndrome coronavirus 2
drug DRUGBANK Ceftriaxone
drug DRUGBANK Atovaquone
drug DRUGBANK Azithromycin
drug DRUGBANK Oxygen
disease VO Imovax ID
disease MESH Pneumocystis pneumonia
drug DRUGBANK Spinosad
disease MESH respiratory failure
disease MESH pneumonia
disease IDO immune response

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