Disseminated tuberculosis in a lung transplant recipient presenting as tenosynovitis, subcutaneous nodules, and liver abscesses. (October 2022)

• Record Type: Journal Article
• Authors: Vargas Barahona, Lilian; Henao-Cordero, José; Smith, Joshua; Gray, Alice; Marshall, Carrie B.; Scherger, Sias; Bajrovic, Valida; Koullias, Yiannis
• Is Part Of: Therapeutic advances in infectious disease. Volume 9(2022)
• Publication Date: 2022-10
• Subjects: lung transplant -- mycobacterium infections -- organ donation -- tenosynovitis -- tuberculosis -- tuberculosis screening; Communicable diseases -- Treatment -- Periodicals; Infection -- Treatment -- Periodicals; 616.905
• DOI: 10.1177/20499361221132153
• Languages: English
• ISSNs: 2049-9361

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.