Challenges in Liver transplant and risk factors and implications associated with opportunistic infection Mycobacterium Tuberculosis
Journal Title: Stanley Medical Journal - Year 2016, Vol 3, Issue 3
Abstract
Introduction: Mycobacterium tuberculosis can cause significant infections in liver transplant candidates and recipients. Its nonspecific clinical features and prolonged growth time in culture make the diagnosis difficult. Active TB in transplant patients is difficult to treat because of drug-induced hepatotoxicity and the significant interaction between rifampin and calcineurin inhibitors. We report a rare case of post transplant tuberculosis and discuss its presentation and successful management. Methods: We report a case of successful liver transplant for hepatic failure who developed opportunistic pulmonary tuberculosis infection. Clinical Picture: A 42-year-old female underwent liver transplant for cryptogenic liver failure. After four years of postliver transplant presented initially with fever, acute confusion and rapidly progressive right middle lobe pneumonia, and was diagnosed with pulmonary tuberculosis by positive sputum smear for acid-fast bacilli (Mycobacterium) culture. Individualized standard anti-tuberculosis therapy was administered with immunosuppressant and successfully managed. Conclusion: A high level of suspicion, prompt anti-tuberculosis treatment and close follow-up are essential in management of post-transplant tuberculosis.
Authors and Affiliations
Murali Ramamoorthy, Tony Fredrick, Manimaran M, Chitra S, Malarvizhi M, Venkateswaran A. R, Revathy M. S, Yuvaraj Jayaraman, Pradeep A Menon, Joseph K David
Keywords
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