Tuberculous Abscess of the Graft in a Renal Transplant Recipient after Chronic Rejection.
- Author:
In Seok CHOI
1
;
Jae Berm PARK
;
Sung Joo KIM
;
Jae Won JOH
;
Suk Koo LEE
;
Woo Seong HUH
;
Ha Young OH
;
Sung Min KIM
;
Kyung Ran PECK
;
Jae Hoon SONG
;
Byung Boong LEE
Author Information
1. Department of Surgery, Samsung Medical Center,Sungkyunkwan University School of Medicine, Korea.
- Publication Type:Case Report
- Keywords:
Renal transplantation;
Tuberculous abscess
- MeSH:
Abscess*;
Adult;
Allografts;
Bone Marrow;
Female;
Fever;
Humans;
Immunosuppression;
Incidence;
Kidney;
Kidney Transplantation;
Lung;
Mortality;
Opportunistic Infections;
Renal Dialysis;
Renal Insufficiency;
Transplantation*;
Transplants*;
Tuberculosis
- From:The Journal of the Korean Society for Transplantation
1999;13(2):345-347
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Tuberculosis is a significant opportunistic infection in transplant recipients under the immunosuppressed condition, though not common and also known to have higher incidence among transplant recipients than in general population. The most common form of tuberculosis among transplant recipients is pulmonary, gastrointestinal, bone and genital tract in decreasing order. However tuberculous infection of the transplanted graft is rare and usually associated with disseminated tuberculosis with high mortality. We experienced M.. tuberculosis infection of the renal allograft after chronic rejection. A 28-year-old female received living-related renal transplantation, required high-dose steroid therapy for two episodes of acute rejection (8 and 20 months later). However, she eventually became renal failure due to chronic rejection and immunosuppression therapy was discontinued. Patient was refered back to our institute for the hemodialysis (post-transplant 40 months) when the patient was found to have pulomary tuberculosis of miliary type. Antituberculosis medication (INH, RFP, EMB & PZA) was immediately started on the basis of positive cultures from lung and bone marrow specimen for M. tuberculosis. In spite of full medication, high fever was sustained and subsequently pyonephritis of grafted kidney was detected and infected graft was removed to confirm the tuberculosis is very serious disease among immunosuppressed transplant patient and therefore more aggressive approach is needed including the search for the hidden infection even at the failed graft with cessated function
