MYCOBACTERIUM TUBERCULOSIS INFECTION OF A NATIVE POLYCYSTIC KIDNEY FOLLOWING RENAL TRANSPLANTATION:

Background Tuberculosis is a recognized complication following renal transplantation. Patients with autosomal dominant polycystic kidney disease are increasingly being offered renal transplantation as an alternative to chronic hemodialysis. These patients are uniquely susceptible to serious upper urinary tract infections that are associated with significant morbidity and mortality. While involvement with Gram-negative organisms is well described, mycobacterial infection of native polycystic kidneys after transplantation has not been addressed. Methods. A case report of a renal transplant recipient who suffered an isolated Mycobacterium tuberculosis infection of a native polycystic kidney and a literature review. Results. Despite appropriate drug therapy, the infection proved refractory, and the patient required nephrectomy. Conclusions. Mycobacterial tuberculosis, though not common, must be recognized as a potential source of infection of native polycystic kidneys in immunocompromised transplant recipients. Similar to the pattern observed with more common pathogens, these infections may be difficult to eradicate with standard antimicrobial drug regimens.