title: Disseminated Mycobacterium haemophilum infection in a renal transplant recipient.
abstract: Opportunistic infections are a major concern in renal and transplant medicine. We present the case of a renal transplant recipient with a generalised Mycobacterium haemophilum infection after an increase in immunosuppressive therapy and treatment with a tumour necrosis factor-α (TNF-α) inhibitor. Infection involved skin and soft tissue, joints and bones, as well as the renal transplant with an interstitial nephritis. Rapid diagnosis using PCR and DNA sequencing allowed early appropriate treatment. Triple antibiotic therapy and reduction in immunosuppression resulted in a slow but sustained recovery. Immunosuppression causes severe opportunistic infections. TNF-α inhibitors are very effective and well tolerated but have an increased susceptibility to infections with mycobacteria. Mycobacterial infections represent a significant clinical risk to transplant recipients because of their aggressive clinical course and the need for complex toxic antibiotic treatments. In these patients, M. haemophilum is a cause of skin infections.
authors: Medical Clinic, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors: Silke R
authors: SR
authors: Brix
authors: Medical Clinic, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors: Christof
authors: C
authors: Iking-Konert
authors: Medical Clinic, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors: Rolf A K
authors: RA
authors: Stahl
authors: Medical Clinic, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors: Ulrich
authors: U
authors: Wenzel
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D001706:Biopsy; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D008297:Male; D009164:Mycobacterium Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology*; D018393:Mycobacterium haemophilum / Q000302:isolation & purification*; D009894:Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology*
chemical_list: D000995:Antitubercular Agents; D007166:Immunosuppressive Agents