title: The role of ultrasound and echo-color Doppler in the diagnosis and follow-up of tuberculosis of the transplanted kidney.
abstract: Tuberculosis is still a relatively frequent, serious disease developing in kidney transplant patients, having an overall incidence estimated to range between 0.35 and 15%. The disease often presents with unusual clinical manifestations, partly due to the more frequent extra-pulnipnary localizations. We describe the clinical case of a 49-year-old patient who had undergone a bilateral kidney transplant from a 70-year-old donor. About 8 months after the transplant he developed fever and raised serum creatinine values were found, together with subcutaneous abscesses in the groin, along both surgical wounds, and on the external genital area. Ultrasound and radiographic imaging demonstrated the presence of multiple intra-abdominal abscesses, localized at the level of the spleen hilus, of the left transplanted kidney and the right parietocolic retroperitoneum. Positive cultures were obtained to Mycobacterium Tuberculosis and the patient was administered anti-tubercular treatment with Etambutol, Isoniazide, and Rifabutin. The initially prescribed immune suppressive treatment (Corticosteroids, Cyclosporin and Micophenolate) was progressively reduced to only 5 mg/die of Prednisone. After 6 months from the start of the anti-tubercular treatment the patient showed an improvement of the clinical and radiological picture, as well as preservation of the renalfunction.
authors.affiliation: Dipartimento dell'Emergenza e dei Trapianti di Organi, Università di Bari, Italy.
authors.forename: Silvano
authors.initials: S
authors.lastname: Palazzo
authors.forename: Pasquale
authors.initials: P
authors.lastname: Martino
authors.forename: Michele
authors.initials: M
authors.lastname: Battaglia
authors.forename: Pasquale
authors.initials: P
authors.lastname: Ditonno
authors.forename: Roberto
authors.initials: R
authors.lastname: Peschechera
authors.forename: Oscar
authors.initials: O
authors.lastname: Selvaggio
authors.forename: Francesco Paolo
authors.initials: FP
authors.lastname: Selvaggi
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D014398:Tuberculosis, Renal / Q000000981:diagnostic imaging* / Q000209:etiology; D018615:Ultrasonography, Doppler, Color