We have a post renal transplant pt. on triple immunosupressants, - TopicsExpress

We have a post renal transplant pt. on triple immunosupressants, admitted with dry cough,dyphagis,altered sensorium. sodium was low -corrected, after 2 days he started wheezing/dyspnea and fever. we done ct-chest , FOB done-revealed ascaris and klebsiella in BAL. Put on poly-b and bandy plus (ivermectin+albendazole), immunosuppressants stopped except low dose hydrocort (50mg od). within 5 days pts condition worsened, repeat ct shows resolution of dense consolidated areas but new interstitial shadows appeared all over lungs specially upper lobes, mild blood streaked sputum, pt was not in fluid overload,producing good amount of urine,2-DEcho-fine, AEC-normal,no fever. .....what could be the reason for patient and HRCT deterioration and what should we follow ?

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