Nontuberculous mycobacterial pulmonary infection in renal transplant recipients

The most common presentations of nontuberculous mycobacterial infections in kidney transplant recipients (KTR) are cutaneous and disseminated diseases. Pleuropulmonary infection not associated with disseminated disease is rare. Its diagnosis can be difficult, requiring a combination of clinical, radiological, and bacteriological criteria. We report on a Mycobacterium avium complex pulmonary infection in a KTR with underlying chronic obstructive pulmonary disease. Chest computed tomography showed an excavated lesion of the right upper lobe, similar to a typical lesion of pulmonary tuberculosis. Evolution was favorable with multiple-drug therapy including rifampicin, ethambutol, and clarithromycin, along with a slight reduction in immunosuppression. We review the literature and discuss the epidemiology, diagnosis, management, and follow-up of this uncommon post-transplant complication.