Unusual cause of epidural abscess in a renal transplant recipient

Fungal infections cause morbidity and mortality in renal transplant recipients. The causative agent and risk factors differ depending on the time after transplantation. Invasive aspergillosis (IA) though rare is a life-threatening complication occurring in renal transplant recipients. Although pulmonary involvement is the most common presentation of IA, the spectrum is broad. Spinal cord involvement by aspergillus is rare and can present as paraspinal abscess, epidural abscess, vertebral osteomyelitis, discitis, or spinal cord necrosis. We report here a case of aspergillus epidural abscess in a 24-year-old male renal transplant recipient presented with paraplegia and successfully treated with surgery and antifungals. High index of suspicion and prompt diagnosis is very much essential for better outcome. Emerging fungal infections, different mode of presentation and its management is a great challenge to the treating nephrologist and physician.