Specific meningoencephalitis in patients with transplanted kidney
Journal of Clinical Nephrology
We described a case of specifi c (tuberculous) encephalitis in a patient after kidney transplantation. Immunosuppressive therapy, continuously required in post-tranplant period, may cause various complications, such as infections. Specifi c meningoencephalitis is an infection that is rarely diagnosed and more common in immunocompromised patients. Case report: A 30-year-old man had kidney transplantation (kidney donor was his father). He previously was two years on chronic hemodialysis treatment
... odialysis treatment because of end-stagerenal disease based on diabetic nephropathy. He has diabetes type 1. The early post-transplant period duly passed with satisfactory clinical and laboratory parameters of renal function. Two months after transplantation, he presented with febrile condition, signs of septicemia and dehydration with signifi cant neurological defi cit and expressed meningeal signs. In cerebrospinal fl uid we found lymphocytosis, elevated proteins and positive micobacterium tuberculosis antibodies (Hexagon method) and we suspected to specifi c etiology of meningitis. Performed computed tomography (CT) scan of the brain with contrast confi rmed the expected fi nding. Due to the poor prognosis of infections of the central nervous system (CNS) in immunocompromised patients, only prompt diagnosis can improve survival in this group of patients. The therapeutic protocol after kidney transplantation include the prophylactic use of antituberculous drug (Isoniazid 300 mg) during the 9 months.