Mycobacteriosis and Nocardiosis in the Immunocompromised Host

Barber, Thomas W.; Sugar, Alan M.

doi:10.1007/978-1-4615-2490-8_9

Cited by 5 publications

(3 citation statements)

References 254 publications

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“…Risk factors for mycobacterial infection were present in several patients (6): (a) Significant radiological abnormalities suggestive for previous tuberculosis disease were present in 1 patient; (b) 2 were from non‐Caucasian ethnic background; (c) and/or 8 had other immunosuppressive conditions like protein‐calorie malnutrition, correlated with increased risk for mycobacterial infections (see Table 3 and section on Net state of immunosuppression) and (d) one patient had a history of previous M. tuberculosis infection that was adequately treated 28 years prior to transplantation; after transplantation she developed an infection with atypical mycobacteria. In 53 of all renal transplant patients, M. tuberculosis infection was diagnosed and treated prior to transplantation.…”

Section: Resultsmentioning

confidence: 99%

“…However, the mean age of this population was 69 years compared with 50 years in the present study, but the figures in haemodialysis are probably underestimated because of the uraemic immune defect. In the majority of patients, risk factors for mycobacterial infection were present (6). Factors affecting the net state of immunosuppression seemed to be very important: 8 patients had a viral infection, 6 patients a body mass index (BMI) below 20, and 5 patients presented with an uraemia higher than 90 mg/dL.…”

Section: Discussionmentioning

confidence: 99%

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Mycobacterial infection after renal transplantation in a Western population

Vandermarliere¹,

Audenhove²,

Peetermans³

et al. 2003

Transplant Infectious Dis

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Mycobacterial infection is a serious opportunistic infection in renal transplant recipients. The incidence is higher in developing than in developed Western countries. This study is a single-centre retrospective review of the records of 2502 renal transplant recipients in Belgium. Fourteen cases of mycobacterial infection (9 Mycobacterium tuberculosis and 5 atypical mycobacterial infection) were diagnosed. The time interval between transplantation and diagnosis was 64 +/- 80 months (mean +/- SD, range 5-188) for M. tuberculosis and 92 +/- 75 months (range 14-209) for atypical mycobacterial infection. The localisation of M. tuberculosis was pulmonary/pleural in 67% and extrapulmonary in 33%. The atypical mycobacterial infections were located in skin, tendons, and joints. Eight patients received IV prednisolone pulse therapy for acute rejection long before the time of mycobacterial infection. The initial antimycobacterial therapy consisted of a combination of isoniazid, rifampicin, and ethambutol in all patients. In patients with M. tuberculosis infection, a good response to antimycobacterial therapy was obtained. In patients with atypical mycobacterial infection, initial treatment was successful in 3 out of 5 patients, in 1 patient recurrence was diagnosed and in another patient, who is still under treatment at present, the initial treatment was adjusted after identification of the atypical mycobacterium and its antibiogram. The incidence of mycobacterial infection after renal transplantation did not increase with newer immunosuppressive therapy. The major risk factor is the total dose of corticosteroids. All patients responded well without major reductions in immunosuppressive therapy. Chemoprophylaxis for high-risk patients still is recommended.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Mycobacterial infection after renal transplantation in a Western population

Vandermarliere¹,

Audenhove²,

Peetermans³

et al. 2003

Transplant Infectious Dis

View full text Add to dashboard Cite

show abstract

“…In our experience, 25 percent of patients with nocardial or fungal infection have skin lesions as the first manifestation of the infection. 46,47 Skin lesions are invariably the result of dissemination and provide an accessible diagnostic site. The second notable feature was the pericardial and pleural involvement, with effusion.…”

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confidence: 99%