title: Mycobacterial infection: a difficult and late diagnosis in stem cell transplant recipients.
abstract: The Infectious Diseases Working Party of the European Blood and Marrow Transplant Group conducted a survey to obtain information about the frequency, presentation, and treatment of mycobacterial infection (MBI) in stem cell transplant (SCT) recipients. Among 29 centers, MBI was diagnosed in 0.79% of 1513 allogeneic and 0.23% of 3012 autologous SCT recipients during 1994-1998 a median of 160 days after transplantation. The mean interval between first symptoms and diagnosis was 29 days and was still longer for patients with atypical MBI or recipients of corticosteroid therapy. The prevalence of MBI was highest among those who received matched unrelated or mismatched STCs from related donors. Of 31 patients, 20 had tuberculosis, 8 had atypical MBI, and 3 had diagnoses based on histological findings only. Five patients (16%) died, all of whom had received an allogeneic SCT. Because of the increased numbers of unmatched donors and transplantation programs in countries with a high prevalence of tuberculosis, constant vigilance is required to early detect MBI in SCT recipients.
authors.affiliation: Department of Hematology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France. carlcord@club-internet.fr
authors.forename: C
authors.initials: C
authors.lastname: Cordonnier
authors.forename: R
authors.initials: R
authors.lastname: Martino
authors.forename: P
authors.initials: P
authors.lastname: Trabasso
authors.forename: T K
authors.initials: TK
authors.lastname: Held
authors.forename: H
authors.initials: H
authors.lastname: Akan
authors.forename: M S
authors.initials: MS
authors.lastname: Ward
authors.forename: K
authors.initials: K
authors.lastname: Fabian
authors.forename: A J
authors.initials: AJ
authors.lastname: Ullmann
authors.forename: N
authors.initials: N
authors.lastname: Wulffraat
authors.forename: P
authors.initials: P
authors.lastname: Ljungman
authors.forename: E P
authors.initials: EP
authors.lastname: Alessandrino
authors.forename: J
authors.initials: J
authors.lastname: Pretnar
authors.forename: J
authors.initials: J
authors.lastname: Gmür
authors.forename: R
authors.initials: R
authors.lastname: Varela
authors.forename: A
authors.initials: A
authors.lastname: Vitek
authors.forename: S
authors.initials: S
authors.lastname: Sica
authors.forename: M
authors.initials: M
authors.lastname: Rovira
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009164:Mycobacterium Infections / Q000175:diagnosis / Q000453:epidemiology*; D009894:Opportunistic Infections / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology*