Esophageal tuberculosis with coexisting opportunistic infections in a renal allograft transplant recipient

Transpl Infect Dis. 2017 Feb;19(1). doi: 10.1111/tid.12640.

Abstract

We report a renal allograft transplant recipient with esophageal tuberculosis (TB) coinfected with herpes simplex virus (HSV) and Candida. The patient presented with oropharyngeal candidiasis and was started on fluconazole. Upper gastrointestinal endoscopy showed whitish patches with mucosal ulcers in the esophagus. Histopathological examination confirmed TB and HSV infection. The patient recovered after antiviral, antifungal, and anti-tubercular therapy with reduction in immunosuppression. In a TB-endemic zone, TB can coexist with opportunistic infections in an immunocompromised host.

Keywords: Candida albicans; esophageal tuberculosis; herpes simplex virus; infectious esophagitis; renal transplantation.

Publication types

  • Case Reports

MeSH terms

  • Antifungal Agents / therapeutic use
  • Antitubercular Agents / therapeutic use
  • Antiviral Agents / therapeutic use
  • Candidiasis, Oral / drug therapy
  • Candidiasis, Oral / microbiology
  • Deglutition Disorders / etiology
  • Endoscopy, Gastrointestinal
  • Esophageal Mucosa / pathology
  • Esophagitis / complications*
  • Esophagitis / microbiology
  • Esophagitis / pathology
  • Esophagitis / virology
  • Fluconazole / therapeutic use
  • Herpes Simplex / complications*
  • Herpes Simplex / pathology
  • Herpes Simplex / virology
  • Hiccup / etiology
  • Humans
  • Immunocompromised Host
  • Immunohistochemistry
  • Immunosuppression Therapy / adverse effects*
  • Immunosuppression Therapy / methods
  • Kidney Failure, Chronic / surgery
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Opportunistic Infections / complications*
  • Opportunistic Infections / microbiology
  • Opportunistic Infections / pathology
  • Opportunistic Infections / virology
  • Simplexvirus / isolation & purification
  • Transplant Recipients
  • Transplantation, Homologous / adverse effects
  • Tuberculosis, Gastrointestinal / complications*
  • Tuberculosis, Gastrointestinal / microbiology
  • Tuberculosis, Gastrointestinal / pathology
  • Vomiting / etiology

Substances

  • Antifungal Agents
  • Antitubercular Agents
  • Antiviral Agents
  • Fluconazole