Abstract
Disseminated mycobacterial infections occurred in two female renal graft recipients late after transplantation. In the first patient, initially presenting with fever, diagnosis was made at autopsy. Temporary defervescence following antibiotic therapy with ofloxacin possibly contributed to the fatal diagnostic delay. In the second case, body temperature was normal throughout the protracted course of the patient's illness. Her presenting symptom was rapidly increasing ascites, attributed initially to chronic liver disease. These cases demonstrate that tuberculosis remains a serious complication after renal transplantation, in particular due to its sometimes atypical clinical manifestations. Response to antibacterial therapy has to be critically evaluated in order to avoid fatal diagnostic delay.
References
Andrew OT, Schoenfeld PY, Hopewell PG, Humphreys MH (1980) Tuberculosis in patients with end-stage renal disease. Am J Med 68: 59–64
Ascher NL, Simmons RL, Marker S, Klugman J, Najarian JS (1978) Tuberculous joint disease in transplant patients. Am J Surg 135: 853–856
Coutts II, Jegarajah S, Stark JE (1979) Tuberculosis in renal transplant recipients. Br J Dis Chest 73: 141–148
Des Prez RM, Goodwin RA (1985) Mycobacterium tuberculosis. In: Mandell GL, Douglas GR, Bennett JE (eds) Principles and practice of infectious diseases, 2nd edn. Wiley, New York, pp 1383–1406
Forslund T, Laasonen L, Höckerstedt K, Stenman S, Edgren J (1984) Tuberculosis of the colon in a kidney transplant patient. Acta Med Scand 251: 181–184
Hefty TR, Barry JM (1986) Renal transplantation in Saudi Arabia. Transplant Proc 18 [Suppl 2]: 10–12
Kochhar R, Indudhara R, Nagi B, Yadav RVS, Mehta SK (1988) Colonic tuberculosis due to atypical mycobacteria in a renal transplant recipient. Am J Gastroenterol 83: 1435–1436
Lichtenstein IH, Macgregor RR (1983) Mycobacterial infections in transplant recipients: report of five cases and review of the literature. Rev Infect Dis 5: 216–226
Lloveras J, Peterson PK, Simmons RL, Najarian JS (1982) Mycobacterial infections in renal transplant recipients. Arch Intern Med 142: 888–892
Malhotra KK, Dash SC, Dhawan IK, Bhuyan UN, Gupta A (1986) Tuberculosis and renal transplantation — observations from an endemic area of tuberculosis. Postgrad Med J 62: 359–362
Mourad G, Soulillou JP, Chong G, Pouliquen M, Hourmant M, Mion C (1985) Transmission of mycobacterium tuberculosis with renal allografts. Nephron 41: 82–85
Peters TG, Reiter CG, Boswell RL (1984) Transmission of tuberculosis by kidney transplantation. Transplantation 38: 514–516
Riska H, Kuhlbäck B (1979) Tuberculosis and kidney transplantation. Acta Med Scand 205: 637–640
Rubin RH, Wolfson JS, Cosimi AB, Tolkoff-Rubin NE (1981) Infection in the renal transplant recipient. Am J Med 70: 405–406
Spence RK, Dafoe DC, Rabin G, Grossman RA, Naji A, Barker CF, Perloff LJ (1983) Mycobacterial infections in renal allograft recipients. Arch Surg 118: 356–359
Tsukamura M (1985) In vitro antituberculous activity of a new antibacterial substance ofloxacin (DL 8280). Am Rev Respir Dis 131: 348–351
Tsukamura M, Nakamura E, Yoshii S, Amano H (1985) Therapeutic effect of a new antibacterial substance ofloxacin (DL8280) on pulmonary tuberculosis. Am Rev Respir Dis 131: 352–356
Wood M, Wallin JD, O'Neill W (1983) Disseminated tuberculosis in a renal transplant recipient: presentation as an anterior mediastinal mass. South Med J 76: 1577–1579
Author information
Authors and Affiliations
About this article
Cite this article
Schorn, T.F., Merscher, S., Franz, A. et al. Disseminated tuberculosis after renal transplantation. Transplant Int 3, 113–115 (1990). https://doi.org/10.1007/BF00336215
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00336215