Portal de investigação
Cutaneous Tuberculosis in Heart Transplant
Autores da FMUP
Participantes de fora da FMUP
- Lino, R
- Silva, C
- Neves, N
- Araújo, P
- Pinto, R
- Pinheiro-Torres, J
- Pinho, P
Unidades de investigação
Abstract
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.
Dados da publicação
- ISSN/ISSNe:
- 0041-1345, 1873-2623
- Tipo:
- Article
- Páginas:
- 1444-1448
- Link para outro recurso:
- www.scopus.com
Transplantation Proceedings Elsevier USA
Documentos
- Não há documentos
Filiações
Keywords
- Abscess; Heart Transplantation; Humans; Mycobacterium tuberculosis; Rifampin; Tuberculosis, Cutaneous; adenosine deaminase; alkaline phosphatase; amoxicillin plus clavulanic acid; analgesic agent; atorvastatin; bicarbonate; C reactive protein; carbon dioxide; complement component C4d; cotrimoxazole; creatinine; cyclosporine; diltiazem; ethambutol; gamma glutamyltransferase; glucocorticoid; HLA DQ2 antigen; HLA DR2 antigen; isoniazid; lactate dehydrogenase; lactic acid; levofloxacin; mycophenolate mofetil; oxygen; prednisolone; protein; pyrazinamide; rifampicin; rivaroxaban; tuberculostatic agent; well water; rifampicin; abnormal respiratory sound; abscess; abscess drainage; acid fast bacterium; adult; alkaline phosphatase blood level; anorexia; antibiotic prophylaxis; arterial gas; Article; asthenia; atrioventricular block; bacterial infection; bacterium culture; bicarbonate blood level; blood carbon dioxide tension; blood oxygen tension; blood pH; blood pressure; body weight loss; bre
Proyectos asociados
A Research Study to Look at How Ziltivekimab Works Compared to Placebo in People With Cardiovascular Disease, Chronic Kidney Disease and Inflammation (ZEUS) - NCT05021835
Investigador Principal: José Carlos de Magalhães Silva Cardoso
Ensaio Clínico Comercial (ZEUS) . Novo Nordisk . 2022
Citar a publicação
Lino R,Amorim S,Silva C,Neves N,Araújo P,Pinto R,Pinheiro J,Pinho P,Macedo F,santos L. Cutaneous Tuberculosis in Heart Transplant. Transplant. Proc. 2023. 55. (6):p. 1444-1448. IF:0,900. (4).
