TY - JOUR T1 - Multidrug-resistant tuberculosis in a kidney recipient JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p2627 AU - Ventsislava Pencheva AU - Daniela Petrova AU - Ognian Georgiev Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p2627.abstract N2 - A 38-year-old female, ten years after renal transplantation was referred to hospital with symptoms of fever and chest pain. The chest X-ray showed a massive solitary lession over the left hilus. The thoracic computed tomography detected infiltrative area in first, second and third segments in left lung with bilateral fibrosis and calcifications. The fiberoptic bronchoscopy showed a severe inflammation of the wall of upper left lobe, which was covered with white mucous material, easy bleeding on contact. The results of bronchoalveolar lavage were microbiological and histological negative for tuberculosis (TB) and other bacterial pathogens. The immunology test for TB (T-spot.TB) was positive. Due to the CT finding and positive T-SPOT.TB was started triple tuberculostatic therapy till the culture result for TB become ready. 34 days later the patient was re-hospitalized with fever and meningitis instead of the treatment. The result of the lumbal punction was lymphocyte liquid. The result from TB-culture was ready in the same time. Multidrug- resistant TB (MDR-TB) was proved in this patient. Antituberculosis treatment with four medicaments from second line was started.Tuberculosis is a frequent infectious complication in patients on renal replacement therapy, as a result of immunosuppression from uremia and drugs in the post-transplantation period. The frequency of MDR-TB increases in last years. That requires treatment with second line drugs for longer period than patients infected with drug-sensitive strains and is with higher mortality rates. ER -