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Disseminated Mycobacterium gordonae infection in a renal transplant recipient
Author(s) -
Den Broeder A.A.,
Vervoort G.,
Van Assen S.,
Verduyn Lunel F.,
De Lange W.C.,
De Sévaux R.G.L.
Publication year - 2003
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1034/j.1399-3062.2003.00016.x
Subject(s) - medicine , pancytopenia , ethambutol , clarithromycin , bronchoalveolar lavage , immunology , mycobacterium abscessus , pathogen , rifampicin , mycobacterium , cytomegalovirus , kidney transplantation , bone marrow , transplantation , pathology , tuberculosis , virus , viral disease , lung , herpesviridae , helicobacter pylori
The use of more intensive immunosuppressive regimens and the increasing number of patients that are exposed to immunosuppressive strategies in transplantation medicine have changed the spectrum of infections that is encountered by the clinician. We describe a 62‐year‐old female renal transplant recipient receiving immunosuppressive therapy who developed complaints of weight loss, diarrhoea, cough, and fever. Increased C‐reactive protein and pancytopenia were found. The presence of Mycobacterium gordonae , a non‐tuberculous mycobacterium, was eventually demonstrated in bronchoalveolar lavage fluid, bone marrow, spleen, and liver. Determination of the pathogen was accelerated using a Line Probe Assay, a reverse hybridisation technique using an RNA fragment specific for different mycobacterium species. Treatment was initiated using a combination of clarithromycin, ethambutol, and rifampicin. The initial response to treatment was good, but splenectomy and change of immunosuppressive and antimycobacterial therapy were necessary for long‐term control of the infection. Problems in the diagnosis and treatment of this uncommon pathogen are discussed.