Fatal sepsis due to Mycobacterium tuberculosis after allogeneic bone marrow transplantation

Kindler, Thomas; Schindel, Christine; Brass, U; Fischer, Thea Kølsen

doi:10.1038/sj.bmt.1702737

Cited by 21 publications

(19 citation statements)

References 3 publications

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“…[9][10][11][12][13][14][15][16][17][18][19][20][21][22] The data show that the ratio of TB in allogeneic SCT patients correlates with the country's TB rate, as mentioned above (Table IV). Detailed analysis of the same data shows that there is no increased risk of TB in autologous SCT patients, which suggests that there is no need to take extra measures against TB in these patients.…”

Section: Characteristics Of Tb In Sct Patientsmentioning

confidence: 69%

Tuberculosis in stem cell transplant patients

Akan

Arslan

Akan³

2006

Journal of Hospital Infection

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Section: Characteristics Of Tb In Sct Patientsmentioning

confidence: 69%

Tuberculosis in stem cell transplant patients

Akan

Arslan

Akan³

2006

Journal of Hospital Infection

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“…The incidence of M. tuberculosis infections in recipients of HSCT varies considerably according to the type of HSCT and to the geographical location (1, 14, 21, 23, 26–30). The prevalence of M. tuberculosis infections is higher in recipients of solid organ transplant (SOT) than in HSCT presumably due to the longer immunosuppression in SOT recipients (15, 28, 31, 32).…”

Section: Tuberculosis Infections In Recipients Of Hsctmentioning

confidence: 99%

Infections Caused by Mycobacterium tuberculosis in Recipients of Hematopoietic Stem Cell Transplantation

2014

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Mycobacterium tuberculosis (M. tuberculosis) infections are uncommon in recipients of hematopoietic stem cell transplantation. These infections are 10–40 times commoner in recipients of stem cell transplantation than in the general population but they are 10 times less in stem cell transplantation recipients compared to solid organ transplant recipients. The incidence of M. tuberculosis infections in recipients of allogeneic stem cell transplantation ranges between <1 and 16% and varies considerably according to the type of transplant and the geographical location. Approximately 80% of M. tuberculosis infections in stem cell transplant recipients have been reported in patients receiving allografts. Several risk factors predispose to M. tuberculosis infections in recipients of hematopoietic stem cell transplantation and these are related to the underlying medical condition and its treatment, the pre-transplant conditioning therapies in addition to the transplant procedure and its own complications. These infections can develop as early as day 11 and as late as day 3337 post-transplant. The course may become rapidly progressive and the patient may develop life-threatening complications. The diagnosis of M. tuberculosis infections in stem cell transplant recipients is usually made on clinical grounds, cultures obtained from clinical specimens, tissues biopsies in addition to serology and molecular tests. Unfortunately, a definitive diagnosis of M. tuberculosis infections in these patients may occasionally be difficult to be established. However, M. tuberculosis infections in transplant recipients usually respond well to treatment with anti-tuberculosis agents provided the diagnosis is made early. A high index of suspicion should be maintained in recipients of stem cell transplantation living in endemic areas and presenting with compatible clinical and radiological manifestations. High mortality rates are associated with infections caused by multidrug-resistant strains, miliary or disseminated infections, and delayed initiation of therapy. In recipients of hematopoietic stem cell transplantation, isoniazid prophylaxis has specific indications and bacillus Calmette-Guerin vaccination is contraindicated as it may lead to disseminated infection. The finding that M. tuberculosis may maintain long-term intracellular viability in human bone marrow-derived mesenchymal stem cells complicates the development of effective vaccines and strategies to eliminate tuberculosis. However, the introduction of linezolid, cellular immunotherapy, and immunomodulation in addition to autologous mesenchymal stem cell transplantation will ultimately have a positive impact on the overall management of infections caused by M. tuberculosis.

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“…Another report from India Tuberculosis was documented in 2.3% of the transplant patients [3]. They can presents with fatal sepsis as reported by Kindler, T et al [4]. Fungal infection with aspergillus is common in BMT recipient.…”

Section: Discussionmentioning

confidence: 96%

Multi-organ failure due to Mycobacterium tuberculosis and Aspergillus flavus infection after allogeneic bone marrow transplantation

Dolai

Kumar

Bhargava

et al. 2008

Indian J Hematol Blood Transfus

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Mycobacterium tuberculosis (MT) is a serious, but rare infectious complication after allogeneic bone marrow transplantation (BMT). We describe a case of fatal sepsis due to MT and Aspergillus fl avus after allogeneic BMT for Aplastic Anemia. The diagnosis was made on bone marrow biopsy and asitic fl uid culture. Broadspectrum antituberculous and Amphotericin B therapy was started immediately after diagnosis. The patient developed severe hypoxia and fi nally died of multi-organ failure. Rapid progression of mycobacterial infection as well as fungal infection should be considered in patients post BMT with unexplained fever, particularly in patients from endemic areas.

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Fatal sepsis due to Mycobacterium tuberculosis after allogeneic bone marrow transplantation

Cited by 21 publications

References 3 publications

Tuberculosis in stem cell transplant patients

Tuberculosis in stem cell transplant patients

Infections Caused by Mycobacterium tuberculosis in Recipients of Hematopoietic Stem Cell Transplantation

Multi-organ failure due to Mycobacterium tuberculosis and Aspergillus flavus infection after allogeneic bone marrow transplantation

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