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Primary splenic tuberculosis in transplant candidates.
Journal of the National Medical Association
|March 1, 1978
Summary
Incidental spleen lesions resembling tuberculosis were found in two renal transplant candidates. Prompt antituberculous therapy prevented active disease development in these immunosuppressed patients.
Area of Science:
- Nephrology
- Infectious Diseases
- Transplant Surgery
Background:
- Renal transplant candidates require thorough pre-transplant screening for latent infections.
- Tuberculosis can present atypically in immunocompromised individuals.
- Spleen involvement in tuberculosis is uncommon but possible.
Observation:
- Caseous granulomatous lesions, indicative of tuberculosis, were identified in the spleen of two renal transplant candidates.
- Neither patient exhibited clinical signs of active tuberculosis.
- One patient had a positive tuberculin skin test and chest imaging suggesting prior granulomatous disease.
Findings:
- Incidental splenic granulomas prompted antituberculous therapy in both candidates.
- No evidence of active tuberculosis emerged during immunosuppressive therapy.
- Prophylactic treatment appeared effective in preventing disseminated disease.
Implications:
- Highlights the importance of spleen evaluation in transplant candidates.
- Suggests that early antituberculous therapy can be beneficial for latent tuberculosis in this population.
- Underscores the need for vigilance regarding opportunistic infections in renal transplant recipients.