Pulmonary tuberculosis after lung transplantation.
During a 5-year study period, we diagnosed pulmonary tuberculosis in two (2%) of 94 lung and heart-lung transplant recipients. Each infection occurred 3 months after bilateral lung transplantation in the presence of evidence implicating donor-to-recipient transmission of the pathogen. The radiographic patterns of pulmonary tuberculosis were subtle: narrowing of the middle lobe bronchus of the right lung caused by an endobronchial granulomatous mass (n = 1) and a focal cluster of small nodules in the upper lobe of the left lung and small bilateral pleural effusions (n = 1). Each patient achieved complete clinical and radiographic response after antituberculous therapy. We conclude that Mycobacterium tuberculosis may be transmitted directly by a donor lung and may involve bronchial mucosa, pulmonary parenchyma, and pleura.
Schulman
L L
LL
Department of Medicine, College of Physicians & Surgeons of Columbia University, New York, USA.
Scully
B
B
McGregor
C C
CC
Austin
J H
JH
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D001980:Bronchi / Q000382:microbiology; D001982:Bronchial Diseases / Q000000981:diagnostic imaging; D001995:Bronchography; D018562:Disease Transmission, Infectious; D016027:Heart Transplantation / Q000009:adverse effects; D006801:Humans; D008168:Lung / Q000382:microbiology; D016040:Lung Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis; D010994:Pleura / Q000382:microbiology; D010996:Pleural Effusion / Q000382:microbiology; D014019:Tissue Donors; D014375:Tuberculoma / Q000000981:diagnostic imaging; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging / Q000635:transmission*
D000995:Antitubercular Agents