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[Generalized tuberculosis after kidney transplantation].

D V Perlin, S P Darenkov, M A Starostenko

    Urologiia (Moscow, Russia : 1999)
    |January 10, 2001
    PubMed
    Summary
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    Tuberculosis is a severe complication for kidney transplant patients, often presenting with vague symptoms. Early suspicion and treatment of tuberculosis are crucial for improving outcomes in these vulnerable individuals.

    Area of Science:

    • Nephrology
    • Infectious Diseases
    • Transplantation Immunology

    Background:

    • Tuberculosis (TB) poses a significant risk for patients undergoing hemodialysis and kidney transplantation.
    • Disseminated and generalized forms of TB are common in this population, often with subtle, non-specific clinical presentations.

    Observation:

    • An aggressive, generalized form of TB was identified in a kidney transplant recipient.
    • Mycobacterium tuberculosis (M. tuberculosis) antigen and DNA were detected only shortly before the patient's demise.
    • Pulmonary disseminated foci were visualized on CT scans solely during the agonal phase, despite prior radiographic assessments.

    Findings:

    • The study highlights the diagnostic challenges in identifying TB in kidney transplant recipients due to nonspecific symptoms.

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  • Late detection of M. tuberculosis markers and pulmonary lesions underscores the difficulty in early diagnosis.

    • Implications:

    • Fever of unknown origin unresponsive to antibiotics in renal transplant recipients warrants high suspicion for tuberculosis.
    • Prompt initiation of antituberculosis therapy is essential for potentially improving patient prognosis and outcomes.