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Meningoencephalitis with Aspergillus and mycobacterium tuberculosis in a renal transplant recipient

Peyman Petramfar1, Marzieh Yousefian, Mohammad Hosein Ashraf

  • 1Neurology Department, Shiraz University of Medical Sciences, Shiraz, Iran.

Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation
|May 25, 2011
PubMed
Abstract

Insights

This case study highlights a rare central nervous system coinfection of Aspergillus and Mycobacterium tuberculosis in a renal transplant recipient. Despite treatment, the patient experienced rapid deterioration, emphasizing the critical nature of opportunistic infections post-transplant.

Area of Science:

  • Infectious Diseases
  • Nephrology
  • Neurology

Background:

  • Renal transplant recipients are immunocompromised, increasing susceptibility to opportunistic infections.
  • Maintenance immunosuppression (mycophenolate mofetil, prednisolone, cyclosporine) can predispose patients to severe infections.

Observation:

  • A 33-year-old woman presented with fever and focal neurological deficits one month post-renal transplant.
  • Brain MRI demonstrated multiple ring-enhancing lesions, suggestive of infectious or neoplastic processes.

Findings:

  • Cerebrospinal fluid PCR confirmed coinfection with Aspergillus species and Mycobacterium tuberculosis.
  • The patient received broad-spectrum antibiotics, antitubercular agents, and amphotericin B.

Implications:

  • This case underscores the challenge of diagnosing and treating polymicrobial opportunistic CNS infections in transplant patients.
  • Aggressive and timely diagnosis is crucial, though outcomes can be poor despite intensive therapy.

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