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A Case Report of Lumbar Abscess in a Transplant Recipient: Is It Always What It Seems?
Alejandra Amarilla González1, Marcia Solange De Oliveira Rotela1, Rossana Mabel Vera Duarte1
1Nephrology Department of Clinics Hospital, Mariscal Lopez and Cruzada de la Amistad, San Lorenzo, Paraguay.
Abstract:
The percentage of solid organ transplant recipients who develop extrapulmonary or disseminated tuberculosis (TB) is higher than the general population. In countries where the disease is endemic, TB should always be considered a diagnostic possibility, and extrapulmonary disease should also be considered. We present the case of a kidney transplant patient who initially presented for an abscess in the left dorsolateral region and was ultimately diagnosed with pulmonary and extrapulmonary TB. With the initiation of antibacillary treatment, a drug interaction with immunosuppressants was verified, and rifampicin was maintained at a minimum dose with other antibacillary drugs at full dose, subsequently showing an improvement in the clinical picture. The adverse effects of TB treatment present great difficulty owing to the interactions of antibacillary drugs with immunosuppressants. Most patients with conventional treatment can be cured, so prompt diagnosis and treatment are important.
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