Tomography patterns of pneumonia caused by various etiologic agents during the first year after kidney transplantation

Abstract

Objective:

To evaluate the tomography patterns of pneumonia attributed to various etiological agents during the first year after kidney transplantation.

Materials and Methods:

We analyzed the medical records of 956 patients who underwent kidney transplantation between 2013 and 2018 at a transplant center in northeastern Brazil. Among the kidney transplant recipients who developed pneumonia, the etiologic agents were categorized as pyogenic bacteria, mycobacteria, fungi, viruses, or polymicrobial pneumonia. The tomography patterns were categorized as consolidation, bronchopneumonia, interstitial pneumonia, or nodules/masses. To determine the statistical association between the causative microorganism and the tomography pattern, we used Fisher’s exact test, for which the level of significance was set at p < 0.001.

Results:

Among 101 cases of pneumonia reported in kidney transplant recipients, the etiologic agent was identified in 60 (59.4%), the most common category being pyogenic bacteria, which were implicated in 22 cases (36.7%). Among the 60 patients in whom had the causal agent was identified, the pattern in which nodules and masses predominated was the most common, being identified in 25 cases (41.7%). We detected associations between pyogenic bacteria and consolidation, between fungi and nodules/masses, and between viruses and interstitial pneumonia.

Conclusion:

There were statistical associations between tomography patterns and the microorganisms that cause pneumonia. This knowledge could facilitate the treatment planning for kidney transplant patients.

Keywords:
Pneumonia; Kidney transplantation; Computed tomography