TABLE 962 Etiology of Infection by Time from Transplant

A history of recent or repeated rejections may also suggest the presence of increased levels of immunosuppression. During a rejection episode, increased immunosuppression is commonly used, which increases the risk of infection.

Infection in a transplant recipient may be either reactivation of a chronic infection or a new infection from exposure to contagious contacts. A complete exposure history of the patient and the patient's recent contacts can provide important clues to possible infections.

PHYSICAL EXAMINAIION Renal transplant patients are immunocompromised; a high index of suspicion is required to find infections in unusual sites ( Xabie-m 9.6.z3.). In addition to the common sites of infection (skin, pulmonary tract, and genitourinary tract), the head, neck, rectum, and abdomen should be closely scrutinized for infection. Infections during the first 12 weeks posttransplant are most commonly related to the surgical procedure of engraftment. Special attention should be given to the renal graft, and the examiner should look for signs of wound infection, pyelonephritis, and urine leakage with infection.

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