Cutaneous Tuberculosis in Heart Transplant

• Type: Another Publication in an International Scientific Journal
• Date: 2023

Authors

Lino, R (Author) Other; Amorim, S (Author) FMUP; Silva, C (Author) Other; Neves, N (Author) FMUP; Araújo, P (Author) Other; Pinto, R (Author) Other; Pinheiro Torres, J (Author) Other; Pinho, P (Author) Other; Macedo, F (Author) Other; santos, l (Author) FMUP

Journal

Title: Transplantation Proceedings

ISSN: 0041-1345

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 0 Citations

Scopus - 0 Citations

Other information

Authenticus ID: P-00Y-BST

DOI: 10.1016/j.transproceed.2023.03.041

Abstract (EN): Tuberculosis is a disease with a significant global burden in terms of morbidity and mortality. It usually presents as a pulmonary disease but can occasionally have extrapulmonary presentations. Immunosuppressed people are at an increased risk of tuberculosis and more frequently have atypical manifestations of the disease. Cutaneous involvement is estimated to occur in only 2% of extrapulmonary presentations. We report a case of a heart transplant recipient with disseminated tuberculosis who initially presented with cutaneous manifestations in the form of multiple abscesses that were mistaken for a community-acquired bacterial infection. The diagnosis was made after positive nucleic acid amplification testing and cultures for Mycobacterium tuberculosis from the drainage of the abscesses. After initiating antituberculous treatment, the patient had 2 instances of immune reconstitution inflammatory syndrome. A combination of diminished immunosuppression due to discontinuation of mycophenolate mofetil in the setting of acute infection, rifampin drug interactions with cyclosporine, and the beginning of treatment of tuberculosis all contributed to this paradoxical worsening. The patient responded favorably to increased glucocorticoid therapy and showed no signs of treatment failure after 6 months of antituberculous therapy.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 5