Post Kidney Transplant Tuberculosis in Nigeria: A Case Report

Abstract

Background: Tuberculosis has been reported to be one of the most serious bacterial infections after transplant and occur up to 20 times more frequently in transplant
recipients than in the general population. Renal transplant is available in few centers in the country and the post transplant population is increasing, but to our knowledge
no case of post transplant tuberculosis has been reported in this environment.
Method: The case report of a 35 year old Nigerian who had live related kidney transplant and later developed post transplant disseminated Tuberculosis is presented and the relevant literature is reviewed.
Results: A 35 year old university graduate had a live related kidney transplant in our center. He had stable allograft function on immunosuppressive regimen consisting of Cyclosporin, Azathioprine and Prednisolone, and presented with features of disseminated tuberculosis involving the cervical lymph nodes and chest with associated deterioration of allograft
function. He was successfully treated with 2 months initial phase of quadruple anti tuberculosis drugs including Isoniazid, Rifampicin, Pyrazinamide and Ethambutol and
four months continuation phase with Isoniazid and Rifampicin. He showed remarkable clinical improvement and reversal of the allograft dysfunction.
Conclusion: This case illustrates one of the post transplant infectious complications seen in our environment and its successful treatment, and highlighted the need for Tuberculosis prophylaxis in transplant recipients in countries with high incidence of tuberculosis.

Keywords: Tuberculosis, Kidney transplant, Nigeria

Nigerian Journal of Medicine Vol. 17 (2) 2008: pp. 217-219