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Ghosh A, Verma P, Jha V, Gupta K, Sakhuja V, Chugh K. Disseminated Tuberculosis in a Renal Transplant Recipient Presenting as a Non-Healing Skin Ulcer. A Case Report. Int J Artif Organs 2018. [DOI: 10.1177/039139889301600305] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cutaneous tuberculosis in renal allograft recipients is rare. A 33 year old recipient of a second renal allograft developed a painless ulcer on the left foot two months after surgery, followed by the appearance of a cold abscess in the left inguinal region. Smear from the pus aspirated from this abscess revealed acid fast bacilli, and biopsy from the edge of the ulcer showed an epitheloid cell granuloma with Langhans type of giant cells. X-ray of the chest revealed miliary mottling in both lung fields. Antitubercular therapy lead to a complete resolution of the tuberculous lesions
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Affiliation(s)
- A.K. Ghosh
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh - India
| | - P.P. Verma
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh - India
| | - V. Jha
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh - India
| | - K.L. Gupta
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh - India
| | - V. Sakhuja
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh - India
| | - K.S. Chugh
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh - India
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Jurewicz WA, Miles A. Strategies for ensuring effective surveillance in post-transplant patients: practical organization and clinical evaluation. J Eval Clin Pract 2004; 10:37-56. [PMID: 14731150 DOI: 10.1111/j.1365-2753.2003.00408.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Results of renal transplantation have improved steadily over the years. This article reviews the current status of patient and graft survival and discusses major causes of mortality and renal allograft failure. Review of recent literature demonstrates that the traditional enemies of transplantation, acute rejection and opportunistic infections are no longer major problems facing transplantation. Chronic graft nephropathy and death with functioning graft due to cardiovascular disease are the main challenges in the current era. An impact of an early graft thrombosis, recurrent renal disease and post-transplant malignancies are also reviewed. Chronic graft nephropathy is examined in a context of differences between two calcineurin inhibitors, cyclosporin microemulsion and tacrolimus. Strategies of post-transplant surveillance are suggested.
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Affiliation(s)
- W Adam Jurewicz
- Department of Surgery, University of Wales College of Medicine, Cardiff, UK.
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Pien FD, Younoszai BG, Pien BC. Mycobacterial infections in patients with chronic renal disease. Infect Dis Clin North Am 2001; 15:851-76. [PMID: 11570145 DOI: 10.1016/s0891-5520(05)70176-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In this article, the authors have provided a comprehensive review of TB and MOTT infections in patients on renal dialysis and receiving kidney transplants. Because most published series are small retrospective studies or case reports, there are several uncertainties still involved in the diagnosis and treatment of such patients. Unanswered questions include selection of optimal dosage and duration of therapeutic agents; the best tests for screening and diagnosis, especially in high prevalence areas; and the best management of MOTT infections because of unavailability of highly effective therapy.
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Affiliation(s)
- F D Pien
- University of Hawaii, John A. Burns School of Medicine, Straub Clinic and Hospital, Honolulu, Hawaii
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Kasiske BL, Vazquez MA, Harmon WE, Brown RS, Danovitch GM, Gaston RS, Roth D, Scandling JD, Singer GG. Recommendations for the outpatient surveillance of renal transplant recipients. American Society of Transplantation. J Am Soc Nephrol 2001. [PMID: 11044969 DOI: 10.1681/asn.v11suppl_1s1] [Citation(s) in RCA: 392] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Many complications after renal transplantation can be prevented if they are detected early. Guidelines have been developed for the prevention of diseases in the general population, but there are no comprehensive guidelines for the prevention of diseases and complications after renal transplantation. Therefore, the Clinical Practice Guidelines Committee of the American Society of Transplantation developed these guidelines to help physicians and other health care workers provide optimal care for renal transplant recipients. The guidelines are also intended to indirectly help patients receive the access to care that they need to ensure long-term allograft survival, by attempting to systematically define what that care encompasses. The guidelines are applicable to all adult and pediatric renal transplant recipients, and they cover the outpatient screening for and prevention of diseases and complications that commonly occur after renal transplantation. They do not cover the diagnosis and treatment of diseases and complications after they become manifest, and they do not cover the pretransplant evaluation of renal transplant candidates. The guidelines are comprehensive, but they do not pretend to cover every aspect of care. As much as possible, the guidelines are evidence-based, and each recommendation has been given a subjective grade to indicate the strength of evidence that supports the recommendation. It is hoped that these guidelines will provide a framework for additional discussion and research that will improve the care of renal transplant recipients.
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Affiliation(s)
- B L Kasiske
- Division of Nephrology, Hennepin County Medical Center, University of Minnesota, Minneapolis 55415, USA.
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Affiliation(s)
- A K Sharma
- Monilek Hospital and Research Centre, Jaipur, India
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Asano T, Kawamoto H, Asakuma J, Tanimoto T, Kobayashi H, Hayakawa M. Paradoxical worsening of tuberculosis after anti-TB therapy in a kidney transplant recipient. Transplant Proc 2000; 32:1960-2. [PMID: 11120020 DOI: 10.1016/s0041-1345(00)01512-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- T Asano
- Department of Urology, National Defense Medical College, Tokorozawa, Saitama, Japan
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Jha V, Sakhuja V, Gupta D, Krishna VS, Chakrabarti A, Joshi K, Sud K, Kohli HS, Gupta KL. Successful management of pulmonary tuberculosis in renal allograft recipients in a single center. Kidney Int 1999; 56:1944-50. [PMID: 10571806 DOI: 10.1046/j.1523-1755.1999.00746.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Pulmonary infections, especially tuberculosis, are responsible for significant mortality and morbidity among renal transplant recipients in developing countries. Conventional diagnostic modalities are associated with a low yield, delaying specific therapy. METHODS All patients transplanted within a 1.5-year period were prospectively followed-up for one year. Patients were on a cyclosporine-based triple immunosuppressive regimen. None received isoniazid prophylaxis, and those transplanted in the last seven months of the study period received daily cotrimoxazole. Patients exhibiting unequivocal evidence of pulmonary infections underwent further evaluation. Search for offending organisms was made by sputum examination and bronchoalveolar lavage (BAL). RESULTS . Thirty-nine infection episodes were recorded in 34 patients. M. tuberculosis was isolated during 10 episodes, pyogenic bacteria and Pneumocystis carinii in 6 each, candida in 4, aspergillus in 3, cytomegalovirus (CMV) in 3, and nocardia and mucor in one episode each. More than one organism was isolated during five episodes. Bacterial pneumonia and tuberculosis were diagnosed in another seven and two patients, respectively, on the basis of a therapeutic response to specific chemotherapy. Over two thirds of the organisms were identified by examination of BAL fluid. BAL was useful in the diagnosis of tuberculosis and P. carinii pneumonia but was relatively insensitive for CMV and bacterial infections. An increased frequency of acute rejection and higher serum creatinine were factors that predisposed to infections. All patients with pulmonary tuberculosis made a full recovery. CONCLUSIONS Tuberculosis and P. carinii are the most common nonpyogenic infections in the first year after transplantation in developing countries. An aggressive search for tubercle bacilli should be made using bronchoscopy and examination of BAL fluid in patients not responding to a short trial of antibiotics. A four-drug regime without rifampicin given for 18 months is effective for pulmonary tuberculosis in patients on cyclosporine. We recommend routine prophylactic use of one single-strength tablet of cotrimoxazole daily for at least six months after transplantation.
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Affiliation(s)
- V Jha
- Department of Nephrology, Postgraduate Institute of Medical Education, Chandigarh, India
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Aguado JM, Herrero JA, Gavaldá J, Torre-Cisneros J, Blanes M, Rufí G, Moreno A, Gurguí M, Hayek M, Lumbreras C, Cantarell C. Clinical presentation and outcome of tuberculosis in kidney, liver, and heart transplant recipients in Spain. Spanish Transplantation Infection Study Group, GESITRA. Transplantation 1997; 63:1278-86. [PMID: 9158022 DOI: 10.1097/00007890-199705150-00015] [Citation(s) in RCA: 216] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Tuberculosis is unusual in transplant recipients. The incidence, clinical manifestations, and optimal treatment of this disease in this population has not been adequately defined. The present study was undertaken to assess the incidence, clinical features, and response to therapy of Mycobacterium tuberculosis infection in solid-organ transplant recipients. METHODS We evaluated retrospectively the incidence, clinical characteristics, diagnostic procedures, antituberculous treatment, clinical course, and factors influencing mortality in 51 solid-organ transplant recipients who developed tuberculosis after transplantation. We also reviewed the world literature on tuberculosis in solid-organ transplantation. RESULTS The overall incidence of tuberculosis was 0.8%. The localization was pulmonary in 63% of the cases, disseminated in 25%, and extrapulmonary in 12%. Tuberculosis developed from 15 days to 13 years after surgery (mean, 23 months). In one third of the cases, diagnosis was not suspected initially, and in three cases, diagnosis was made at necropsy. Fever was the most frequent symptom, followed by constitutional symptoms, cough, respiratory insufficiency, and pleuritic pain. Fifteen patients (33%) developed hepatotoxicity during treatment; hepatotoxicity was severe in seven cases. Hepatotoxicity was higher in patients receiving four or more antituberculous drugs (50%) than in patients receiving three drugs (21%; P=0.03). Serum levels of cyclosporine decreased in the 26 patients under the simultaneous use of rifampin. Nine of them (35%) developed acute rejection, and five (56%) died, in comparison with 3 of 17 patients (18%) who did not develop rejection after the use of cyclosporine and rifampin (P=0.03). Although microbiological response was favorable in 94% of the 35 patients who completed 6 or more months of treatment, 16 other patients (31%) died before diagnosis or in the course of treatment. None of the patients treated for more than 9 months died as a consequence of tuberculosis, whereas the mortality rate was 33% among those treated for 6 to 9 months (P=0.03). Use of antilymphocyte antibodies or high doses of steroids for acute rejection before tuberculosis was associated with a higher mortality rate. CONCLUSIONS M tuberculosis causes serious and potentially life-threatening disease in solid-organ transplant recipients. Treatment with at least three drugs during 9 months or more, avoiding the use of rifampin, appears to be appropriate.
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Affiliation(s)
- J M Aguado
- Department of Microbiology, Hospital 12 de Octubre, Madrid, Spain
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Kim SI, Kim MS, Kim YS, Park K. Is pulmonary tuberculosis a major risk factor on patient and graft survival in kidney transplantation? Transplant Proc 1997; 29:820. [PMID: 9123541 DOI: 10.1016/s0041-1345(96)00148-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- S I Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
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Abstract
Solid-organ transplantation is a therapeutic option for many human diseases. Infections are a major complication of solid-organ transplantation. All candidates should undergo a thorough infectious-disease screening prior to transplantation. There are three time frames, influenced by surgical factors, the level of immunosuppression, and environmental exposures, during which infections of specific types most frequently occur posttransplantation. Most infections during the first month are related to surgical complications. Opportunistic infections typically occur from the second to the sixth month. During the late posttransplant period (beyond 6 months), transplantation recipients suffer from the same infections seen in the general community. Opportunistic bacterial infections seen in transplant recipients include those caused by Legionella spp., Nocardia spp., Salmonella spp., and Listeria monocytogenes. Cytomegalovirus is the most common cause of viral infections. Herpes simplex virus, varicella-zoster virus, Epstein-Barr virus and others are also significant pathogens. Fungal infections, caused by both yeasts and mycelial fungi, are associated with the highest mortality rates. Mycobacterial, pneumocystis, and parasitic diseases may also occur.
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Affiliation(s)
- R Patel
- Division of Infectious Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA
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Sakhuja V, Jha V, Varma PP, Joshi K, Chugh KS. The high incidence of tuberculosis among renal transplant recipients in India. Transplantation 1996; 61:211-5. [PMID: 8600625 DOI: 10.1097/00007890-199601270-00008] [Citation(s) in RCA: 138] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Tuberculosis is an important infection encountered after renal transplantation in third-world countries. Over an 8-year period, 36 cases of tuberculosis were encountered in 305 renal transplant recipients (11.8%) with grafts functioning for more than 3 months followed up at our center. The infection was limited to the thoracic cavity in 41.7% and a single extrapulmonary site in 11.1%, and it was disseminated in 27.8% cases. In 19.4% of cases, the disease appeared as pyrexia of unknown etiology and the diagnosis was confirmed by a good therapeutic response to antitubercular therapy. Tuberculosis was diagnosed within 1 year of transplantation in 58.3% of cases. There was no significant difference in the incidence of tuberculosis in patients on different immunosuppressive regimens. The Mantoux test was positive in 33.3% patients. A total of 23 patients were treated with isoniazid and rifampicin, with the addition of a third drug for the first 2 months. Treatment was continued for 9 months in 11 cases with isolated pleuropulmonary disease and for 12-15 months in the other 12 patients. The other 13 were on cyclosporine and were given isoniazid, pyrazinamide, and ethambutol for 18 months. Two patients died of fulminant disease and five more died from unrelated causes. No recurrence of disease has been noted in any of the patients after a mean follow-up of 14.6 months. We conclude that the incidence of tuberculosis in renal allograft recipients in third world countries is much higher than that seen in the western world. Most of the cases are encountered in the first posttransplant year. Tuberculosis must be considered seriously in all patients who have prolonged fever of undetermined etiology. Treatment with isoniazid and rifampicin for 9 months is adequate for patients with localized pleuropulmonary disease. In patients on cyclosporine to whom rifampicin cannot be given because of economic considerations, treatment with isoniazid, pyrazinamide, and ethambutol should be given for 18 months.
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Affiliation(s)
- V Sakhuja
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Abstract
The resurgence of tuberculosis and the emergence of drug-resistant strains, coupled with a growing number of immunocompromised patients and a high proportion of susceptible health care workers, have increased our awareness of the possibility of hospital-acquired tuberculosis. Infection control guidelines which aim to prevent dissemination and inhalation of infectious particles include early diagnosis and isolation of infectious patients, particular care during procedures likely to increase the density of the organism in the environment, and regular surveillance of hospital staff.
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Affiliation(s)
- D deWit
- Department of Microbiology, Central Coast Area Health Service, Gosford, NSW
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Mat O, Abramowicz D, Peny MO, Struelens M, Doutrelepont JM, Adler M, Pauw LD, Vanherweghem JL, Kinnaert P, Vereerstraeten P. Tuberculosis presenting as acute hepatitis in a renal transplant recipient. Transpl Int 1994. [DOI: 10.1111/j.1432-2277.1994.tb01281.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Schorn TF, Merscher S, Franz A, Feddersen CO, Frei U, Pichlmayr R, Koch KM. Disseminated tuberculosis after renal transplantation. A report of two cases. Transpl Int 1990; 3:113-5. [PMID: 2206216 DOI: 10.1007/bf00336215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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.
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Affiliation(s)
- T F Schorn
- Department of Nephrology, Medical School Hannover, Federal Republic of Germany
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Schorn TF, Merscher S, Franz A, Feddersen CO, Frei U, Pichlmayr R, Koch KM. Disseminated tuberculosis after renal transplantation: A report of two cases. Transpl Int 1990. [DOI: 10.1111/j.1432-2277.1990.tb01904.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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de Paula FJ, Azevedo LS, Saldanha LB, Ianhez LE, Sabbaga E. Tuberculosis in renal transplant patients. Rev Inst Med Trop Sao Paulo 1987; 29:268-75. [PMID: 3331484 DOI: 10.1590/s0036-46651987000500002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Tuberculosis (TB) was diagnosed in 25 of 466 patients who underwent renal transplant over a period of 15 years. TB developed from 1 month to 9 years post-transplant. In 56% of the cases the onset was within the first post-transplant year. TB affected several isolated or combined organs. Pulmonary involvement was present in 76% of cases, either as isolated pleuro-pulmonary (56%) or associated with other sites (20%). The non-pulmonary sites were: skin, joints, tests, urinary tract, central nervous system and lymphonodules. The diagnosis was confirmed by biopsy in 64% of the cases, by identification of tubercle bacilli in 24% and only at necropsy in 12% Biopsy specimens could be classified in three histological forms: exudative, that occurred in early onset and more severe cases granulomatous in late onset and benign cases; and mixed in intermediate cases. Azathioprine dosages were similar along post-transplant time periods in TB patients and in the control groups; and in TB patients who were cured and who died. The number of steroid treated rejection crises was greater in TB than in the control group. Prednisone doses were higher and the number of rejection crises was greater in TB patients who died than in those who were cured. Fifteen patients were cured and ten died, two of them of causes unrelated to TB. Six of the eight TB-related deaths occurred in the first 6 post-transplant months. The outcome was poor in patients in whom TB arose early in post-transplant period and where the exudative or mixed forms were present; whereas the prognosis was good in patients with late onset and granulomatous form of TB. In one patient TB was transmitted by the allograft.
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Problems of the Immunosuppressed Patient. Clin Transplant 1987. [DOI: 10.1007/978-94-009-3217-3_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Malhotra KK, Dash SC, Dhawan IK, Bhuyan UN, Gupta A. Tuberculosis and renal transplantation--observations from an endemic area of tuberculosis. Postgrad Med J 1986; 62:359-62. [PMID: 3532083 PMCID: PMC2418707 DOI: 10.1136/pgmj.62.727.359] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Ninety-five renal transplant recipients from an endemic area of tuberculosis were investigated to find out the prevalence and course of tuberculosis in pre- and post-transplant periods. Eleven patients had tuberculosis in the pre-transplant period - pulmonary (2), pleural (2), miliary (1), abdominal (2), lymph node (5) and pericardial (1). They were transplanted after antituberculous therapy of 3 to 6 months with satisfactory results. The anti-tuberculous treatment was usually continued for 2 years. Only one of the above 11 patients had evidence of tuberculosis in the post-transplant period. Nine patients developed tuberculosis for the first time in the post-transplant period - pulmonary (4), pleural (1), miliary (1), lymph node (4) and pericardial (1). There was no mortality due to tuberculosis. Thorough search for tuberculosis is mandatory both during pre-transplant assessment and post-transplant follow-up in areas of endemic tuberculosis.
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Bomalaski JS, Williamson PK, Goldstein CS. Infectious arthritis in renal transplant patients. ARTHRITIS AND RHEUMATISM 1986; 29:227-32. [PMID: 3082337 DOI: 10.1002/art.1780290211] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Infectious complications in the renal transplant patient are common, and infecting agents include opportunistic organisms as well as common pathogens. However, we were only able to document 6 patients who had septic arthritis from more than 800 who received a renal transplant at our institution over an 18-year period. Furthermore, only 16 other cases of infectious arthritis have been reported in the literature. All of our patients had an apparent predisposing factor and 3 patients had prior infection with the same organism. The knee was the most commonly infected joint. The initial synovial fluid white blood cell count was usually greater than 30,000 cells/mm3, but 1 patient with viral arthritis initially had noninflammatory fluid. The peripheral blood white blood cell count may not be elevated. All of our cases of initial joint infection occurred by 18 months posttransplant. Blood cultures were positive in 3 of 4 patients with bacterial infection. Followup of these 6 patients averaged 4.3 years. Numerous other rheumatologic syndromes and disorders peculiar to the posttransplant period may mimic a septic joint. Consequently, despite the low frequency of occurrence of septic arthritis, persistent attention to the locomotor system in the transplant patient is warranted.
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Wong KK, Lim ST, Yeung CK, Ng WL, Ong GB. Disseminated tuberculosis in a renal transplant recipient. THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY 1983; 53:173-5. [PMID: 6349603 DOI: 10.1111/j.1445-2197.1983.tb02422.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
A case of disseminated tuberculosis in a renal transplant recipient is presented. Tuberculosis can occur in the early postoperative period and is potentially curable. It should be vigilantly looked for in every case of post-transplant infection.
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Lloveras J, Peterson PK, Simmons RL, Najarian JS. Mycobacterial Infections in Renal Transplant Recipients. ACTA ACUST UNITED AC 1982. [DOI: 10.1001/archinte.1982.00340180046010] [Citation(s) in RCA: 78] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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