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Clinical Challenge
May 9, 2019

Airway Obstruction in a Patient After Kidney Transplant

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, Mayo Clinic Arizona, Phoenix
  • 2Mayo Clinic School of Medicine, Scottsdale, Arizona
JAMA Otolaryngol Head Neck Surg. 2019;145(7):680-681. doi:10.1001/jamaoto.2019.0772

A woman in her 60s with a history of end-stage renal disease who had a kidney transplant 9 months previously presented with progressive cough, dyspnea, and hoarseness. Her history also included chronic gastroesophageal reflux disease and a 14-pack-year smoking history. She initially presented 3 months prior with upper respiratory symptoms, which continued to worsen despite oral antibiotic therapy. Her cough became productive with white, frothy phlegm that was accompanied by fever, wheezing, hoarseness, and fatigue. Her dyspnea worsened in the supine position.