Abstract
We present a case of a male patient with a history of renal allograft transplant four years prior to admission who presented with acute kidney injury. There were initial concerns for acute transplant rejection due to elevated creatinine. Urine cultures were positive for Gardnerella vaginalis. Renal biopsy results were concerning for chronic pyelonephritis. The patient developed hypertension, fever, and hematuria during the hospital course. He was initially treated with metronidazole, vancomycin, and cefepime. Broad-spectrum antibiotics were quickly discontinued, and the patient improved with metronidazole monotherapy. Patients with a history of renal transplants are often immunocompromised and at risk of infection. The few reported cases primarily involve urinary tract infections. There are scarce reports in the literature of G. vaginalis infection in patients with renal allograft transplants, such as in the present case. This case highlights the importance of considering and treating G. vaginalis in patients with renal transplants who present with symptoms of urinary tract infection.