Mycobacterial Infections in Renal Allograft Recipients

Richard K. Spence, MD; Donald C. Dafoe, MD; Gail Rabin, MD; Robert A. Grossman, MD; Ali Naji, MD; Clyde F. Barker, MD; Leonard J. Perloff, MD
Arch Surg. 1983;118(3):356-359. doi:10.1001/archsurg.1983.01390030086014.
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• Primary mycobacterial infections developed in five of 565 patients who had transplants during a 15-year period. All had negative PPDs and normal chest roentgenograms; none had tuberculosis before transplantation. Atypical mycobacteria were cultured in three of five infections. All were treated with a multiple-drug regimen, including isoniazid, rifampin, ethambutol, and streptomycin sulfate. In four of five patients, there were serious drug-related complications. No major initial alteration of immunosuppressive therapy was necessary in any of the patients. During the study, a treatment policy was followed that Included one year of isoniazid treatment of all recipients with a positive PPD, history of tuberculosis, chest x-ray film suggestive of tuberculosis, or PPD-positive donor. An additional 14 transplant recipients were treated in accordance with this policy without complications or subsequent mycobacterial infections (32-month average follow-up). Despite the low Incidence of mycobacterial Infection in this series, the potential lethality and morbidity mandate constant vigilance.

(Arch Surg 1983;118:356-359)


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