A unique case of tuberculosis dissemination presenting as cutaneous lesions in a post allogeneic stem cell transplant patient

Lam, Wilson; Viswabandya, Auro; Hussain, Shabbir; Messner, Hans A.; Michelis, Fotios V.; Kim, D D; Lipton, Jeffrey H.; Deotare, Uday

doi:10.1038/bmt.2016.137

Cited by 6 publications

(8 citation statements)

References 10 publications

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“…Details on pretransplant TB exposure or history were reported in three cohort studies and eight case reports . Of the 38 patients, majority (26/38, 68.…”

Section: Resultsmentioning

confidence: 99%

“…Information regarding GVHD was provided in 4 of 5 cohorts and 7 case reports . Upon review, information on GVHD was provided in 33 TB cases.…”

Section: Resultsmentioning

confidence: 99%

“…We found a total of 16 studies that described 47 unique cases of TB in the adult HSCT population during the study period: three retrospective reviews, 8-10 two prospective cohorts, 11,12 and 11 case reports. [13][14][15][16][17][18][19][20][21][22][23] Of these, nine were published by centers from Asia. 8,10,11,[17][18][19][20][21][22]…”

Section: Re Sultsmentioning

confidence: 99%

“…Details on pretransplant TB exposure or history were reported in three cohort studies [9][10][11] and eight case reports. [13][14][15][17][18][19][20]23 Of the 38 patients, majority (26/38, 68. 4%) had no known history of TB exposure, while 12 (31.6%) had remote history of active tuberculosis.…”

Section: Clinical and Radiographic Characteristicsmentioning

confidence: 99%

“…Information regarding GVHD was provided in 4 of 5 cohorts [8][9][10][11] and 7 case reports. [13][14][15][16][17][18]21 Upon review, information on GVHD was provided in 33 TB cases. Of these, chronic GVHD and acute GVHD occurred in 28/33 (84.8%) and 13/33 (39.4.6%) recipients, respectively.…”

Section: Characteristicmentioning

confidence: 99%

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An update on Mycobacterium tuberculosis infection after hematopoietic stem cell transplantation in adults

Abad

Razonable

2018

Clinical Transplantation

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Background Mycobacterium tuberculosis (TB) is common worldwide, but is rarely reported after hematopoietic transplantation (HSCT). We reviewed all TB cases among HSCT since 2010 to provide an update on its epidemiology, clinical presentation, management and outcome. Methods Several databases were reviewed from January 1, 2010 to June 30, 2018 using key words tuberculosis and hematopoietic transplantation. Results The 47 cases of TB were reported during the study period. The highest TB frequency was reported from India (2.9%), with a median frequency of 2% (range, 0.18%‐2.9%). The majority were recipients of allogeneic transplants (45/47, 95.7%). Pulmonary TB was the most common clinical presentation (20/47, 42.6%). The median time to clinical presentation was 4.6 (range, 3‐12.9) and 2.4 (range, 0.6‐5) months, based on cohort data and case reports, respectively. Fever was reported in 87.5% (14/16) of patients. First‐line quadruple drug therapy was frequently used (29/35, 82.9%), with a median length of 12 and 9 months for cohorts and case reports, respectively. All‐cause and attributable mortality was 27.6% (13/47), and 8.5% (4/47), respectively. Conclusions Mycobacterium tuberculosis presents early after HSCT, most commonly as fever. A high index of suspicion is needed for early diagnosis and treatment, to prevent TB‐attributable mortality.

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“…Details on pretransplant TB exposure or history were reported in three cohort studies and eight case reports . Of the 38 patients, majority (26/38, 68.…”

Section: Resultsmentioning

confidence: 99%

“…Information regarding GVHD was provided in 4 of 5 cohorts and 7 case reports . Upon review, information on GVHD was provided in 33 TB cases.…”

Section: Resultsmentioning

confidence: 99%

Section: Re Sultsmentioning

confidence: 99%

Section: Clinical and Radiographic Characteristicsmentioning

confidence: 99%

Section: Characteristicmentioning

confidence: 99%

See 3 more Smart Citations

An update on Mycobacterium tuberculosis infection after hematopoietic stem cell transplantation in adults

Abad

Razonable

2018

Clinical Transplantation

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Immunosuppressants

2018

Reactions Weekly

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Disseminated Tuberculosis With an Atypical Cutaneous Manifestation in a Hematopoietic Cell Transplant Patient in the Early Posttransplant Period: Case Report and Review of the Literature

Czech

Dioverti

Karaba

et al. 2022

Open Forum Infectious Diseases

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We describe an unusual case of post-transplant tuberculosis reactivation in a man who underwent allogeneic hematopoietic cell transplant. Concomitant with disseminated adenovirus infection, reactivation of tuberculosis manifested as disseminated, non-follicular pustules on day +49. Skin biopsy was obtained on day +50. Initial histopathologic evaluation did not suggest mycobacterial infection, but tissue stain showed acid-fast organisms, which were subsequently identified as Mycobacterium tuberculosis. Shortly following the cutaneous presentation of tuberculosis, the patient died on day +52. Our case is among a paucity of reports describing tuberculosis reactivation in hematopoietic cell transplant patients in the early post-transplant period. It highlights the difficulty of diagnosing contemporaneous systemic infections, and it presents a rare and atypical cutaneous manifestation of tuberculosis in a hematopoietic cell transplant patient. Our case and review of the literature emphasize the need for further research to elucidate risk factors associated with early post-transplant reactivation of tuberculosis, and the importance of remaining vigilant for active tuberculosis in hematopoietic cell transplant patients with epidemiologic risk factors.

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A unique case of tuberculosis dissemination presenting as cutaneous lesions in a post allogeneic stem cell transplant patient

Cited by 6 publications

References 10 publications

An update on Mycobacterium tuberculosis infection after hematopoietic stem cell transplantation in adults

An update on Mycobacterium tuberculosis infection after hematopoietic stem cell transplantation in adults

Immunosuppressants

Disseminated Tuberculosis With an Atypical Cutaneous Manifestation in a Hematopoietic Cell Transplant Patient in the Early Posttransplant Period: Case Report and Review of the Literature

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