title: Nocardiosis in tropical renal transplant recipients.
abstract: BACKGROUND
  The epidemiology of nocardiosis in the tropics among renal transplant recipients has not been reported.
  
  
  METHODS
  An evaluation of nocardiosis for 30 yr in one of the large transplant centres in South Asian region.
  
  
  RESULTS
  Of the 1968 patients who received primary renal allografts at Christian Medical College & Hospital, 27 patients developed nocardiosis over 30 yr. Early nocardiosis (</= 2 yr) was associated with chronic liver disease and the use of cyclosporin (CsA) as compared with its later occurrence (>2 yr). Seventeen patients (63%) had two or more associated post-transplant infections, of whom 10 had tuberculosis. Mortality in these patients was associated with chronic liver disease.
  
  
  CONCLUSIONS
  Nocardiosis manifests earlier (<2 yr) in CsA treated patients who have chronic liver disease. Among renal transplant recipients of the tropics nocardiosis is a marker of a high susceptibility to tuberculosis and other infections, the association with tuberculosis is stronger in those developing early nocardiosis (<2 yr). Chronic liver disease is a risk factor for death in patients with nocardiosis especially when associated with tuberculosis. This report constitutes the largest single centre experience among renal transplant recipients.
authors.affiliation: Department of Nephrology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India. george@cmcvellore.ac.in
authors.forename: George T
authors.initials: GT
authors.lastname: John
authors.forename: Viswanathan
authors.initials: V
authors.lastname: Shankar
authors.forename: Abi M
authors.initials: AM
authors.lastname: Abraham
authors.forename: Mary S
authors.initials: MS
authors.lastname: Mathews
authors.forename: Paulose P
authors.initials: PP
authors.lastname: Thomas
authors.forename: Chakko K
authors.initials: CK
authors.lastname: Jacob
mesh_terms: D000328:Adult; D002908:Chronic Disease; D015331:Cohort Studies; D016572:Cyclosporine; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D016030:Kidney Transplantation; D008107:Liver Diseases / Q000150:complications / Q000453:epidemiology; D008297:Male; D009617:Nocardia Infections / Q000150:complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014329:Tropical Climate; D014376:Tuberculosis / Q000150:complications / Q000453:epidemiology
chemical_list: D016572:Cyclosporine