Cho J-H, Yu C-H, Jin M-K, Kwon O, Hong K-D, Choi J-Y, Yoon S-H, Park S-H, Kim C-D, Kim Y-L
Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
Transpl Infect Dis. 2012 Oct;14(5):E50-5. doi: 10.1111/j.1399-3062.2012.00767.x. Epub 2012 Jul 23.
Mycobacterium kansasii is the second most common non-tuberculous mycobacteria in kidney transplant recipients (KTRs) and has been reported to cause disseminated infection in KTRs. We report the first case to our knowledge of M. kansasii pericarditis after kidney transplantation in a 54-year-old man. The patient was admitted with a 2-month history of intermittent fever and myalgia, treated with oral prednisolone and mycophenolate mofetil prior to admission. Chest computed tomography showed enlarged mediastinal lymph node and small amount of pericardial effusion. Mediastinoscopic biopsy of mediastinal lymph node revealed reactive hyperplasia, without evidence of granuloma, but acid-fast bacilli stain of pericardial fluid reported positive finding and pericardial fluid culture identified M. kansasii. The patient has been treated successfully with rifabutin-based combination therapy. All available cases of M. kansasii infection in kidney transplant patients and M. kansasii pericarditis in human immunodeficiency virus-infected patients are comprehensively reviewed.
堪萨斯分枝杆菌是肾移植受者（KTRs）中第二常见的非结核分枝杆菌，据报道可在KTRs中引起播散性感染。据我们所知，我们报告了首例肾移植后发生堪萨斯分枝杆菌心包炎的病例，患者为一名54岁男性。该患者因间歇性发热和肌痛2个月入院，入院前接受口服泼尼松龙和霉酚酸酯治疗。胸部计算机断层扫描显示纵隔淋巴结肿大和少量心包积液。纵隔淋巴结的纵隔镜活检显示反应性增生，无肉芽肿证据，但心包液抗酸杆菌染色报告为阳性结果，心包液培养鉴定为堪萨斯分枝杆菌。该患者已通过基于利福布汀的联合疗法成功治疗。我们对肾移植患者中所有已报道的堪萨斯分枝杆菌感染病例以及人类免疫缺陷病毒感染患者中的堪萨斯分枝杆菌心包炎病例进行了全面综述。
