title: Nontuberculous mycobacteria infection in solid organ transplant recipients.
abstract: Although advances in surgical technique, drug-induced immunosuppression, and supportive medical therapy have led to improved survival and quality of live after solid organ transplantations, infections still represent a major threat for transplant recipients.Infections with non tuberculous mycobacteria (NTM) are infrequent, but can be associated with relevant morbidity and mortality. With the exception of few comprehensive studies, the available literature consists predominantly of case reports and institutional experiences. This article reviews NTM infection in the setting of solid organ transplant (SOT) recipients dealing with clinical features, diagnosis, treatment and outcome. Published studies have documented a protean presentation of NTM infection in SOT recipients which may include skin and soft tissue lesions, osteoarticular infections and pleuropulmonary disease. An aggressive approach including histopathologic examination and acid-fast bacilli culture of aspirates or biopsy specimens from involved sites are essential for diagnosis. A combined treatment of debridement surgery, reduction of immunosuppressive medications and/or antimycobacterial drugs is frequently associated with a favorable outcome. It is strongly emphasized that a high index of suspicion for NTM infection should be maintained when managing SOT recipients with unusual clinical manifestations. Early diagnosis and initiation of therapy are essential to prevent morbidity and mortality in this vulnerable population.
authors: Regional Reference Mycobacteria Laboratory, United Hospitals, via Conca 71, 60020, Ancona, Italy. piersim@tin.it
authors: C
authors: C
authors: Piersimoni
mesh_terms: D000995:Antitubercular Agents / Q000008:administration & dosage; D001431:Bacteriological Techniques / Q000379:methods; D003646:Debridement; D006801:Humans; D016867:Immunocompromised Host; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D009170:Nontuberculous Mycobacteria / Q000302:isolation & purification*; D009894:Opportunistic Infections / Q000175:diagnosis* / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D014180:Transplantation; D019737:Transplants / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D000995:Antitubercular Agents