Mycobacterial coronary arteritis in a heart transplant recipient

A case of mycobacterial vasculitis in a chronically rejected transplanted heart is described. The coronary arteries were the only vessels involved by mycobacteria, although the patient had a generalized infection. The process of chronic rejection, with persistent injury to the intimal vascular lining of a transplanted organ, may lead to defects in the endothelial cell barrier and thus facilitate infiltration of a vessel wall by acid-fast bacilli.