Nontuberculous mycobacteria (NTM) infections in kidney transplant recipients (KTR) are rare. We describe here a 52-year-old female with vertebral osteomyelitis caused by NTM, who received a kidney transplant 5 years earlier. She had been diagnosed with NTM lung disease 1 year prior. NTM therapy was delayed due to esophageal candidiasis. Mycobacterium intracellulare was isolated from sputum and bone tissue. The pattern of drug-susceptibility testing in both specimens was identical. NTM vertebral osteomyelitis due to direct inoculation is rare, and was in this case a disseminated NTM disease. The subjective symptoms resolved after 4 months of NTM treatment. This suggests that early NTM treatment is important for KTRs who have NTM disease during immunosuppressive therapy.
Bone and Bones ; Candidiasis ; Female ; Humans ; Kidney ; Kidney Transplantation ; Lung ; Lung Diseases ; Mycobacterium avium Complex ; Nontuberculous Mycobacteria ; Osteomyelitis ; Sputum ; Transplants

BACKGROUND: The purpose of this study was to evaluate the incidence of contrast-induced nephropathy (CIN), and the effect of intravenous albumin for prophylaxis of CIN in patients with liver cirrhosis (LC) and chronic kidney disease (CKD). METHODS: We conducted a retrospective study of 81 subjects with LC and CKD (estimated glomerular filtration rate (eGFR)<60mL/min/1.73m2) who underwent contrast-enhanced computed tomography (CT). Patients received either isotonic sodium bicarbonate solution (3mL/kg for 1h before CT and 1mL/kg/h for 6h after CT) or albumin (20% albumin, 25mL for 1h before CT and 75mL for 6h after CT). CIN was defined as an increase of > or =25% or > or =0.5mg/dL in serum creatinine level. RESULTS: Overall, CIN developed in three patients (3.7%). Of the 81 subjects, 43 received sodium bicarbonate solution and 38 received albumin. Both groups were comparable with regard to age, sex, diabetes mellitus, and baseline eGFR. The albumin group showed a significantly poorer liver function profile. CIN incidence did not differ significantly between the groups: it occurred in one (2.3%) of the 43 subjects receiving sodium bicarbonate and two (5.3%) of the 38 subjects receiving albumin (P=0.6). However, the albumin group showed a significantly smaller increase in body weight (P=0.03). CONCLUSION: The incidence of CIN in patients with LC and CKD undergoing contrast-enhanced CT after preventive measures was relatively low. The incidence of CIN was not significantly different between sodium bicarbonate and albumin groups.
Body Weight ; Creatinine ; Diabetes Mellitus ; Glomerular Filtration Rate ; Humans ; Incidence ; Liver ; Liver Cirrhosis ; Renal Insufficiency, Chronic ; Retrospective Studies ; Sodium Bicarbonate