Nontuberculous mycobacterial pulmonary infection in renal transplant recipients.
The most common presentations of nontuberculous mycobacterial infections in kidney transplant recipients (KTR) are cutaneous and disseminated diseases. Pleuropulmonary infection not associated with disseminated disease is rare. Its diagnosis can be difficult, requiring a combination of clinical, radiological, and bacteriological criteria. We report on a Mycobacterium avium complex pulmonary infection in a KTR with underlying chronic obstructive pulmonary disease. Chest computed tomography showed an excavated lesion of the right upper lobe, similar to a typical lesion of pulmonary tuberculosis. Evolution was favorable with multiple-drug therapy including rifampicin, ethambutol, and clarithromycin, along with a slight reduction in immunosuppression. We review the literature and discuss the epidemiology, diagnosis, management, and follow-up of this uncommon post-transplant complication.
Ho
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TA
Division of Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain Medical School, Brussels, Belgium.
Rommelaere
M
M
Coche
E
E
Yombi
J-C
JC
Kanaan
N
N
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use*; D017291:Clarithromycin / Q000627:therapeutic use; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009162:Mycobacterium avium; D009894:Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D013183:Sputum / Q000382:microbiology; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*
D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents; D007166:Immunosuppressive Agents; D017291:Clarithromycin