Pneumonia Caused by Fungus, Pneumocystis Jirovecii and Cytomegalovirus Coinfection in Patient with Renal Transplantation -A Case Report-

Renal transplantation has become a well-established, definitive , highly successful therapy for end stage renal disease and been increased in previous decades. Korean Network for Organ Sharing reports that renal transplantation has been performed over 800 cases per year during five years. Although graft survival after renal transplantation has increased with the development of numerous new immunosupressive agents, infectious complications remain a significant cause of morbidity and mortality in renal transplant recipients.Cytomegalovirus (CMV) is a major virus in organ transplant recipients and is associated with opportunistic superinfection with a range of different microorganisms including Pneumocystis jirovecii, fungi, gram negative bacterias. In this paper, we report a case of pneumonia caused by fungus, Pneumocystis jirovecii, CMV in patient with renal transplantation. Based on the strong suspicion of superinfection, we aggressively diagnosed by performing surgical method and successfully treated the condition. Patients with CMV pneumonitis may be predisposed to superinfection by other pathogen and is associated with high mortality. Therefore, if superinfection is suspected, prompt diagnosis involving invasive methods and early initiation of antiviral, antifungal therapy are essential to reduce the mortality.