Ureaplasma parvum causes hyperammonemia presenting as refractory status epilepticus after kidney transplant

Hyperammonemia syndrome due to Ureaplasma urealyticum in a kidney transplant recipient: A case of disseminated disease from a fluoroquinolone‐resistant isolate

“…Some clinicians have used empiric treatment with two antibiotics, 6,9,11 although resistance of these organisms to the usually effective antimicrobials (fluoroquinolones, macrolides, tetracyclines) is considered rare 12,13 . To our knowledge, seven cases of HS in kidney transplant (KT) recipients have been published to date 9,14‐19 . Four were attributed to infection, two from Mycobacterium spp., 15,18 one from U parvum , 19 and one from Ureaplasma spp 11 .…”

“…12,13 To our knowledge, seven cases of HS in kidney transplant (KT) recipients have been published to date. 9,[14][15][16][17][18][19] Four were attributed to infection, two from Mycobacterium spp., 15,18 one from U parvum, 19 and one from Ureaplasma spp. 11 We present a unique case of HS caused by U. urealyticum infection in a KT recipient.…”

Successful management of noncirrhotic hyperammonemia syndrome after kidney transplantation from putative Ureaplasma infection

“…Since this series was published, there have been a few additional reports of NCH due to urease‐producing organisms in KT recipients. Two recent reports by Nowbakht et al and Legouy et al 7,12 describe fatal cases of NCH due to urease‐producing organisms, with both cases treated with levofloxacin and doxycycline.…”

“…It is predominantly associated with lung transplantation, 1 with just a few cases reported in kidney transplant (KT) patients. [1][2][3][4][5][6][7] Its presenting features include nausea, vomiting, lethargy, altered mental status, seizure, and encephalopathy. Although its exact mechanism is unknown, 1 possible etiologies include immunosuppressive agents, 8 urea cycle defects, 9 and urea-splitting bacterial infections.…”

“…Noncirrhotic hyperammonemia (NCH) is a rare but often fatal complication of solid organ transplantation. It is predominantly associated with lung transplantation, 1 with just a few cases reported in kidney transplant (KT) patients 1‐7 . Its presenting features include nausea, vomiting, lethargy, altered mental status, seizure, and encephalopathy.…”