• Vol. 34 No. 2, 213–215
  • 15 March 2005

Tuberculosis Post-Liver Transplantation: A Rare but Complicated Disease



Introduction: Tuberculosis is a rare but serious complication after transplantation. We report a case and discuss its presentation and management. Clinical Picture: A 60-year-old Indonesian male presented initially with fever, acute confusion and rapidly progressive right upper lobe pneumonia 3.5 months post-liver transplant, and was diagnosed with pulmonary tuberculosis by positive sputum smear for acid-fast bacilli and tuberculosis culture. Treatment/Outcome: Standard anti-tuberculosis therapy was administered but was complicated by interaction with cyclosporine and drug-induced cholestasis. Conclusion: A high level of suspicion, prompt anti-tuberculosis treatment and close follow-up are essential in management of post-transplant tuberculosis.

Tuberculosis (TB) is a serious opportunistic infection in transplant recipients, with an incidence in organ transplant recipients ranging from 0.35% in developed countries to 15% in endemic areas.1 It carries a mortality rate of as high as 40%.2 The majority of TB infection have occurred within 12 months of transplant. Reactivation of TB and, rarely, nocosomial acquisition or donor transmission are considered to be the most frequent modes of acquisition of TB.1 We describe a case of pulmonary TB developing 3.5 months after orthotopic liver transplant (OLT).

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