A challenging presentation of pyrexia and macroscopic hematuria in a kidney transplant patient

Kidney transplant kidney transplant (KTx) recipients have increased susceptibility to a spectrum of infections including; bacterial, viral, and fungal pathogens. Many factors contribute to their infection potential risk, in terms of their immunosuppressive state, that result in suppression of their B-and T-lymphocyte repertoire, also to consider certain donor and recipient-related factors, that make them at risk of specific type of infectious complications. In addition kidney transplant patients tolerate poorly infections, which may adversely affect their graft function, by inducing glomerular injury, hence early diagnosis, directed therapy, and careful dosing of antimicrobial agents is of paramount importance in reducing patient's morbidity and mortality. We report a kidney transplant patient, who received her live related kidney graft 7 years earlier (in 2013), she has been with stable graft function in most of her follow up period, until she presented with pyrexia, dyspnea and fatigue associated with deterioration of her graft function.