*Purpose: This study sought to describe the epidemiology of Invasive fungal disease at a brazilian kidney transplant center.

*Methods: We retrospectively evaluated the diagnoses of invasive fungal infection in kidney transplant patients between January 2015 and October 2018.

*Results: In this period, 17 transplant patients were diagnosed with Invasive fungal disease, with an incidence of 4% (excluding candidiasis and trichosporonosis). The majority of these infections were presented late in the transplant course, with a median of 34.7 months after kidney transplantation. Cryptococcosis infection was the leader cause, diagnosed in 7 patients (41.2%), followed by Histoplasmosis, 5 cases (29.4%) and Aspergillosis, 5 cases (29.4%). The lung was the main organ affected (47%), followed by the central nervous system (41%). A total of two patients (12%) presented disseminated form with involvement of more than two organs.

Most of the patients were using a triple immunosuppressive regimen with prednisone, tacrolimus and mycophenolate sodium (70.5%) and 42% of patients had been treated for acute rejection prior to the infection. Amphotericin B lipid complex was the main antifungal used. In 42% of cryptococcosis infections required association of fluconazole due to persistence of positive culture (in Brazil there is no availability of flucitocin for association with amphotericin). More than half of the patients had acute graft dysfunction during treatment, but without impact on patient or graft survival until the end of the study. Patient and graft survival at 30 months was 77.2% and 62.7% respectively.

*Conclusions: As in other brazilian cohorts, we also documented a high proportion of late fungal infection with cryptococcosis predominance in kidney transplant patients.

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