Acute pancreatitis, pancreatic pseudocyst, and candida peritonitis in recipient of a kidney transplant

The case of a recipient of a kidney transplant who developed pancreatitis, complicated by pancreatic pseudocyst subsequently infected by Candida from an infected parenteral alimentation line, is reported. The case was further complicated by rupture of the cyst leading to Candida peritonitis and development of multiple fistulous tracts between the stomach, ileum, and colon. Despite the 50% mortality of acute pancreatitis in patients with transplants and the 50% mortality reported in Candida peritonitis, the patient was successfully treated by cystogastrotomy, peritoneal lavage, and amphotericin B in association with administration of mannitol and reduction of immunosuppression to a minimal level. After eight weeks of total parenteral alimentation, the fistulous tracts spontaneously closed and the patient was discharged with normal renal function.