Disseminated tuberculosis after renal transplantation. A report of two cases.
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.
Department of Nephrology, Medical School Hannover, Federal Republic of Germany.
T F
TF
Schorn
S
S
Merscher
A
A
Franz
C O
CO
Feddersen
U
U
Frei
R
R
Pichlmayr
K M
KM
Koch
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D005260:Female; D005334:Fever / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016030:Kidney Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D013997:Time Factors; D014376:Tuberculosis / Q000175:diagnosis / Q000209:etiology*
D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents; D007166:Immunosuppressive Agents