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Review
. 2017 Mar;96(13):e6173.
doi: 10.1097/MD.0000000000006173.

Transplanted lungs and the "white plague": A case-report and review of the literature

Nadim Cassir  1 , Robin Delacroix, Carine Gomez, Véronique Secq, Martine Reynaud-Gaubert, Pascal-Alexandre Thomas, Laurent Papazian, Michel Drancourt
Affiliations
Review

Transplanted lungs and the "white plague": A case-report and review of the literature

Nadim Cassir et al. Medicine (Baltimore). 2017 Mar.

Abstract

Rationale: Solid organ transplant recipients, especially after lung transplantation, are at increased risk for Mycobacterium tuberculosis pulmonary tuberculosis due to lifelong immunosuppression.

Patient concerns: A 41-year-old woman underwent a second bilateral lung transplantation that was complicated by fatal pulmonary tuberculosis.

Diagnoses: Histological examination of a lung biopsy performed 6 weeks after retransplantation revealed a caseating granuloma and necrosis. Acid-fast bacilli were identified as rifampicin-susceptible M. tuberculosis by real-time polymerase chain reaction (PCR), confirmed by culture 2 weeks later.

Interventions: Our investigation led us to highly suspect that the transplanted lungs were the source of M. tuberculosis transmission.

Lessons: In order to optimize diagnosis and treatment for lung recipients with latent or active tuberculosis, regular assessment of lower respiratory samples for M. tuberculosis, particularly during the 12-month period posttransplant should be implemented. Regarding donor-derived transmission, screening donor grafts with latent tuberculosis by M. tuberculosis real-time PCR in lymphoid and adipose tissues is an option that should be considered.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Chest computed-tomography obtained on day 68 after transplantation. A: Bilateral lung parenchymal nodules with cavity in right lower lobe apical segment. B: Bilateral pleural effusion with nodule in posterior segment of right lower lobe.
See this image and copyright information in PMC

References

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