title: Obstructive airway disease caused by Moraxella catarrhalis after renal transplantation.
abstract: We report a case of severe acute obstructive airway disease 2 months after renal transplantation in a 16-year-old patient with Biedl-Bardet syndrome who was transplanted for end-stage renal failure secondary to cystic kidney disease. Symptoms of severe obstructive airway disease developed 2 months after transplantation under immunosuppression with prednisone, azathioprine, and tacrolimus. The patient did not develop signs of infection; progressive shortness of breath remained the only symptom for several weeks. After extensive diagnostic evaluation, bronchoalveolar lavage revealed Moraxella catarrhalis as the single infectious agent. After 3 weeks of appropriate antibiotic therapy, symptoms of obstructive airway disease were completely relieved. This atypical presentation of Moraxella infection in an immunocompromised host represents a rare complication of renal transplantation, especially in young patients. Special aspects such as frequency, diagnosis, differential diagnosis, and management of this rare complication of renal transplantation in a pediatric patient are discussed.
authors.affiliation: Kinderklinik, Medizinische Hochschule Hannover, Germany. kindernephrologie@mh-hannover.de
authors.forename: K
authors.initials: K
authors.lastname: Seidemann
authors.forename: M
authors.initials: M
authors.lastname: Lauten
authors.forename: M
authors.initials: M
authors.lastname: Gappa
authors.forename: G
authors.initials: G
authors.lastname: Offner
authors.forename: K
authors.initials: K
authors.lastname: Latta
authors.forename: J H
authors.initials: JH
authors.lastname: Ehrich
mesh_terms: D000293:Adolescent; D000402:Airway Obstruction / Q000000981:diagnostic imaging / Q000209:etiology*; D000667:Ampicillin / Q000627:therapeutic use; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D052177:Kidney Diseases, Cystic / Q000150:complications / Q000601:surgery; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery; D016030:Kidney Transplantation; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D001936:Moraxella catarrhalis; D016870:Neisseriaceae Infections / Q000175:diagnosis* / Q000188:drug therapy; D011183:Postoperative Complications; D013407:Sulbactam / Q000627:therapeutic use; D013577:Syndrome; D014057:Tomography, X-Ray Computed
chemical_list: D007166:Immunosuppressive Agents; D000667:Ampicillin; D013407:Sulbactam