title: Donor-derived tuberculosis in an anesthetist after short-term exposure : An old demon transplanted from the past to the present.
abstract: We report a case of a 27-year-old anesthetist who acquired tuberculosis (TB) while performing general anesthesia in a renal transplant (RTX) patient who had donor-derived contagious TB. The anesthetist developed pleural TB 6 months after exposure. Contact investigations (CIs) did not include health care workers (HCWs) of the Department of Anesthesiology, thereby missing the opportunity for the early diagnosis and treatment of TB. Genomic fingerprinting revealed identical Mycobacterium tuberculosis (MT) isolates in the anesthetist and in the RTX patient. The recipient had acquired disseminated TB from the harvested renal graft. The donor (liver and kidneys), a 67-year-old immigrant, had died from brain death by cerebral herniation after a stroke. She had been treated for tuberculosis with a pneumectomy 40 years ago. Since that time, she had been suffering from latent tuberculous infection (TBI), but had been considered to have been cured.
authors.affiliation: Department of Anesthesiology, University of Munich, Marchioninistr.15, 81377, Munich, Germany. Isabel.Freytag@med.uni-muenchen.de.
authors.forename: I
authors.initials: I
authors.lastname: Freytag
authors.affiliation: Department of Surgery, University of Munich, Munich, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Bucher
authors.affiliation: Department of Surgery, University of Munich, Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Schoenberg
authors.affiliation: Department of Surgery, University of Munich, Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Stangl
authors.affiliation: Department of Anesthesiology, University of Munich, Marchioninistr.15, 81377, Munich, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Schelling
mesh_terms: D000328:Adult; D000368:Aged; D000072077:Anesthetists; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use; D005260:Female; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D016030:Kidney Transplantation / Q000009:adverse effects*; D016031:Liver Transplantation / Q000009:adverse effects; D009169:Mycobacterium tuberculosis; D014019:Tissue Donors; D014397:Tuberculosis, Pulmonary / Q000209:etiology* / Q000628:therapy / Q000635:transmission*
chemical_list: D000904:Antibiotics, Antitubercular
keywords: Contact tracing; Health personnel; Infectious disease transmission; Occupational exposure; Organ donor