Abstract
Tuberculosis (TB) is a serious infection in immunocompromised patients, such as solid organ transplant recipients and HIV-infected patients. The diagnosis and treatment in this population present several challenges because of the aspecific clinical manifestations, the difficulty in diagnosis, and the choice of the most appropriate therapeutic regimen. Therapeutic challenges arise from drug-related toxicities, interactions between immunosuppressive, antiretroviral, and antituberculous drugs. We present a case of primary TB infection that occurred 3 years after transplantation in a HIV-and hepatitis C virus-coinfected kidney-pancreas recipient. The infection was successfully treated with no hepatotoxicity or rejection with a non-rifampin-containing regimen.
Copyright © 2011 Elsevier Inc. All rights reserved.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Antiretroviral Therapy, Highly Active
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Antitubercular Agents / therapeutic use
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Antiviral Agents / therapeutic use
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Diabetic Nephropathies / complications
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Diabetic Nephropathies / surgery*
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HIV Infections / complications*
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HIV Infections / diagnosis
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HIV Infections / drug therapy
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HIV Infections / immunology
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Hepatitis C / complications*
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Hepatitis C / diagnosis
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Hepatitis C / drug therapy
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Humans
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Immunocompromised Host
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Immunosuppressive Agents / adverse effects*
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Kidney Failure, Chronic / etiology
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Kidney Failure, Chronic / surgery*
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Kidney Transplantation / adverse effects*
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Male
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Middle Aged
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Pancreas Transplantation / adverse effects*
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Tomography, X-Ray Computed
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Treatment Outcome
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Tuberculosis, Pulmonary / diagnosis
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Tuberculosis, Pulmonary / drug therapy
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Tuberculosis, Pulmonary / immunology*
Substances
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Antitubercular Agents
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Antiviral Agents
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Immunosuppressive Agents