title: Pulmonary tuberculosis in an HIV- and hepatitis C virus-coinfected kidney-pancreas transplant recipient: a case report.
abstract: Tuberculosis (TB) is a serious infection in immunocompromised patients, such as solid organ transplant recipients and HIV-infected patients. The diagnosis and treatment in this population present several challenges because of the aspecific clinical manifestations, the difficulty in diagnosis, and the choice of the most appropriate therapeutic regimen. Therapeutic challenges arise from drug-related toxicities, interactions between immunosuppressive, antiretroviral, and antituberculous drugs. We present a case of primary TB infection that occurred 3 years after transplantation in a HIV-and hepatitis C virus-coinfected kidney-pancreas recipient. The infection was successfully treated with no hepatotoxicity or rejection with a non-rifampin-containing regimen.
authors.affiliation: Department of Clinical Medicine, Section of Infectious Diseases, University of Insubria, Varese, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Dalla Gasperina
authors.forename: M
authors.initials: M
authors.lastname: Tozzi
authors.forename: N
authors.initials: N
authors.lastname: Astuti
authors.forename: M L
authors.initials: ML
authors.lastname: Balsamo
authors.forename: D
authors.initials: D
authors.lastname: Donati
authors.forename: A
authors.initials: A
authors.lastname: Rossi
authors.forename: R
authors.initials: R
authors.lastname: Dionigi
authors.forename: P A
authors.initials: PA
authors.lastname: Grossi
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D000995:Antitubercular Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D003928:Diabetic Nephropathies / Q000150:complications / Q000601:surgery*; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*
chemical_list: D000995:Antitubercular Agents; D000998:Antiviral Agents; D007166:Immunosuppressive Agents