Disseminated tuberculosis in a lung transplant recipient presenting as tenosynovitis, subcutaneous nodules, and liver abscesses

Abstract

Tuberculosis is of particular concern in lung transplant recipients. We present the case of a patient who received a double lung transplant from a deceased donor from Mexico and developed disseminated tuberculosis 60 days post-transplant manifested as tenosynovitis, liver abscesses, and subcutaneous nodules with no definitive lung allograft involvement. The recipient did not have evidence of tuberculosis on explanted lungs, had a negative interferon gamma release assay pre-transplant, and did not have risk factors for this infection. Mycobacterium tuberculosis should remain in the differential diagnosis of early post-transplant infections with atypical presentations, evidence of dissemination, or lack of improvement with appropriate antimicrobial coverage, even in the absence of typical lung findings.

Barriers toward xenotransplantation in Arab World

“…Tuberculosis (TB), a major infection in middle east and sub-Saharan Africa, remains a major complication in many solid organ transplantation. [89][90][91] The use of cyclosporine in immunosuppressive regimens predisposes the patient to an earlier onset TB infection. 92 Rifampicin and rifapentine, an alternative treatment prescribed to latent tuberculosis is preferably used in the pre-transplant rather than in the post-transplant patient.…”

“…Furthermore, treatment of these infectious diseases can interfere with the immunosuppressive regimens prescribed. Tuberculosis (TB), a major infection in middle east and sub‐Saharan Africa, remains a major complication in many solid organ transplantation 89–91 . The use of cyclosporine in immunosuppressive regimens predisposes the patient to an earlier onset TB infection 92 .…”