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April 4, 1977

Pulmonary Tuberculosis in a Renal Transplant Recipient

JAMA. 1977;237(14):1465. doi:10.1001/jama.1977.03270410065026

INFECTIONS have been a frequent and serious complication of renal transplantation.1 Immunosuppressive therapy predisposes patients to a variety of infections with both common and opportunistic organisms. However, only a few cases of pulmonary tuberculosis have been reported. The diagnosis was established by sputum examination in some cases, but it was an incidental finding at autopsy in others.2 The skin test with purified protein derivative proved unreliable and was nonreactive in all the patients.

To our knowledge, this is the first case where tuberculosis was diagnosed on open lung biopsy in a renal transplant patient.

Report of a Case  A 23-year-old man was admitted to Milwaukee County General Hospital in February 1976 with a three-month history of fatigue, dyspnea on exertion, productive cough, and nasal congestion.The patient had congenital, obstructive urologic disease leading to progressive pyelonephritis and eventual renal failure, and he had multiple urologic procedures as a