Tuberculosis - One of the causes of PUO after Liver Transplant in children
A report in the July 2000 issues of the paediatric infectious disease journal has described 6 causes of mycobacterium tuberculosis infection that occurred among 256 paediatric recipients between 1991 and 1998 at kings College Hospital in London. The interval from transplantation to diagnosis ranged from 1 to 17 months with a median time of 8 months. Presenting symptoms include fever in 4 children, cough in 2 and decreased appetite in 2. Cervical lymph adenopathy, deafness, headache, abnormal liver function was each observed in single cases. Three of the children had normal chest x- rays at diagnosis.
The patients were treated for 9 to 18 months with anti tuberculoses drugs. Two children died. 1 of sepsis and multi organ failure. 1 from pulmonary haemorrhage: the other 4 are well. Two of the surviving children developed disseminated TB, as it is common in transplant recipients on high dose immunosuppressant. Family screening for TB was positive in 4 cases. Giorgina Miel Vergani, MD and colleagues who described these cases in the paediatric infectious diseases Journal reiterated that “ tuberculosis after liver transplantation in children is not rare and can contribute to increased mortality” particularly in countries where disease incidence is higher than in Great Britain. Clinicians are urged to consider vaccination of children with stable chronic liver disease. Isoniazid prophylaxis for patients with a history of TB, and inclusion of TB in the differential diagnosis of fever of unknown origin after transplantation should be consider
- Copyright © 2021. Published by MOHAN Foundation
- Keywords: Tuberculosis, causes, PUO, liver transplant, children