Nontuberculous mycobacterial infections after transplantation: a diversity of pathogens and clinical syndromes

Razonable, Raymund R.

doi:10.1111/j.1399-3062.2009.00392.x

Cited by 8 publications

(5 citation statements)

References 28 publications

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“…Infections with non-tuberculous mycobacteria (NTM) are less common but are associated with relevant morbidity and mortality 1. Among renal transplant recipients, the incidence is thought to be between 0.16% and 0.38% 2.…”

Section: Discussionmentioning

confidence: 99%

DisseminatedMycobacterium haemophiluminfection in a renal transplant recipient

et al. 2016

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Opportunistic infections are a major concern in renal and transplant medicine. We present the case of a renal transplant recipient with a generalised Mycobacterium haemophilum infection after an increase in immunosuppressive therapy and treatment with a tumour necrosis factor-α (TNF-α) inhibitor. Infection involved skin and soft tissue, joints and bones, as well as the renal transplant with an interstitial nephritis. Rapid diagnosis using PCR and DNA sequencing allowed early appropriate treatment. Triple antibiotic therapy and reduction in immunosuppression resulted in a slow but sustained recovery. Immunosuppression causes severe opportunistic infections. TNF-α inhibitors are very effective and well tolerated but have an increased susceptibility to infections with mycobacteria. Mycobacterial infections represent a significant clinical risk to transplant recipients because of their aggressive clinical course and the need for complex toxic antibiotic treatments. In these patients, M. haemophilum is a cause of skin infections.

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Section: Discussionmentioning

confidence: 99%

DisseminatedMycobacterium haemophiluminfection in a renal transplant recipient

et al. 2016

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“…Our patient died of a co-infection with M. genavense, a rare nontuberculous mycobacterium, which is mostly found in patients with inherent or acquired immunodeficiency. Recent reports state that these mycobacteria are increasingly being recognized in solid organ transplant recipients, but because of their diversity, therapy is complex and requires a combination of active antimicrobial agents [7,8] . In our case, the actual determination and antimicrobial susceptibility guided our treatment, but soon after start of the combined antimicrobial agents, the patient developed transplant failure and died shortly after.…”

Section: Discussionmentioning

confidence: 99%

Intrathoracic Nocardia-abscess as a cause of haemodynamic instability

Joode

Manson

Son

2014

CRIM

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A 64-year old patient was admitted to our hospital one year after renal transplantation. He complained about headache, cough and fever. Blood cultures revealed Nocardia nova. Because of disseminated disease, he was treated with both co-trimoxazol and meropenem. Eight days later, his condition worsened. A CT-thorax was performed which showed large mediastinal masses and compression of vena cava superior and right atrium. The same evening, he underwent a thoracotomy because of haemodynamic instability. The aspirated pus again showed Nocardia nova. He recovered but developed pleural effusion and again this was positive for Nocardia nova. Both meronem and co-trimoxazol were continued. Six months after diagnosis, he was admitted because of gastro-intestinal bleeding and a mycobacterium species was found in gastric and duodenal biopsies. He was started on claritromycine and myambutol, but developed renal failure. Ten months after diagnosis of disseminated Nocardiosis, he died because of worsening condition and renal failure. No post-mortem examination was performed. Revision of literature showed no other reports of hemodynamic instability by Nocardia-abscesses or compression on vena cava or right atrium.

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“…NTM are a rare cause of disease in immunocompetent hosts. In immunocompromised hosts, disease due to NTM is well documented with an estimated incidence of 0.04% after liver transplantation (1, 2). The common species causing NTM infections after transplantation are MAC, Mycobacterium haemophilum, Mycobacterium kansasii, Mycobacterium abscessus, Mycobacterium chelonae , and Mycobacterium fortuitum .…”

Section: Discussionmentioning

confidence: 99%

“…Compared with the general population, nontuberculous mycobacteria (NTM) infections appear to be more common among solid organ and hematopoietic stem cell transplant recipients (1, 2). The increased predisposition of transplant recipients is likely due to iatrogenic drug‐induced suppression of cell‐mediated immunity.…”

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confidence: 99%

Successful management of primary nontuberculous mycobacterial infection of hepatic allograft following orthotopic liver transplantation for hepatitis C

Singhal

Gates

Malhotra

et al. 2011

Transplant Infectious Dis

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Nontuberculous mycobacteria are a rare cause of disease in solid organ and hematopoietic stem cell transplant recipients. The impact of mycobacterial infections in transplant recipients necessitates prompt diagnosis and early initiation of therapy. However, diagnosis remains difficult and there is a lack of specific recommendations for the choice of anti-mycobacterial drugs, duration of therapy, and monitoring of graft function as well as immunosuppression in these patients. Issues involved in the management are illustrated by an index case of hepatic allograft infection due to Mycobacterium avium complex.

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Nontuberculous mycobacterial infections after transplantation: a diversity of pathogens and clinical syndromes

Cited by 8 publications

References 28 publications

DisseminatedMycobacterium haemophiluminfection in a renal transplant recipient

DisseminatedMycobacterium haemophiluminfection in a renal transplant recipient

Intrathoracic Nocardia-abscess as a cause of haemodynamic instability

Successful management of primary nontuberculous mycobacterial infection of hepatic allograft following orthotopic liver transplantation for hepatitis C

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