Patient-identified health service transformation: an Aboriginal patient's experience with extensive chronic tinea corporis and delayed kidney transplantation wait-listing

Jaqui Hughes, Renae Kirkham, O Aye Min, Heather Hall, Bart Currie, Sandawana William Majoni

Research output: Contribution to journalArticle

Abstract

Extensive chronic tinea corporis (EC-TC) is common in people living in tropical environments and in individuals living with diabetes and chronic kidney disease (CKD). However, adults with end-stage kidney disease (ESKD) who seek kidney transplant (KTx) wait-listing require an infection-free medical clearance. Australian clinical care guidelines suggest tinea corporis is cured by antifungal treatment within 2 weeks in the general population, but there are no specific treatment guidelines for adults with severely reduced kidney function who require haemodialysis.

Aim: To describe factors contributing to delayed KTx wait-listing in a patient with EC-TC.

Method: We undertook a case review to address both treatment response for EC-TC for a 43-year-old female with a history of diabetic nephropathy following haemodialysis initiation, and the time it took for her to achieve KTx wait-listing. Follow-up interviews with the client and supporting clinicians were completed in order to learn more about individual perspectives of care.

Results: We observed cure of EC-TC on day 394, and achievement of KTx wait-listing on day 496. The treatment algorithm used to achieve cure involved extended courses of oral terbinafine (250 mg post-dialysis three times weekly, partial response) and oral fluconazole (cure within 3 weeks; 100 mg weekly at dialysis). Holistic care during KTx workup was valued by the patient.

Conclusion: Delayed cure of EC-TC contributed to delayed KTx wait-listing. The in-depth interviews therefore identified healthcare innovations to assist systematic identification and treatment initiation for EC-TC. Furthermore, specific research to improve the treatment response is recommended."
Original languageEnglish
Pages (from-to)92-96
Number of pages5
JournalRenal Society of Australasia Journal
Volume15
Issue number3
Publication statusPublished - Nov 2019

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