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Richard K. Spence, MD; Donald C. Dafoe, MD; Gail Rabin, MD; Robert A. Grossman, MD; Ali Naji, MD; Clyde F. Barker, MD; Leonard J. Perloff, MD

Arch Surg. 1983;118(3):356-359.

Abstract
• Primary mycobacterial infections developed in five of 565 patients who had transplants during a 15-year period. All had negative PPDs and normal chest roentgenograms; none had tuberculosis before transplantation. Atypical mycobacteria were cultured in three of five infections. All were treated with a multiple-drug regimen, including isoniazid, rifampin, ethambutol, and streptomycin sulfate. In four of five patients, there were serious drug-related complications. No major initial alteration of immunosuppressive therapy was necessary in any of the patients. During the study, a treatment policy was followed that Included one year of isoniazid treatment of all recipients with a positive PPD, history of tuberculosis, chest x-ray film suggestive of tuberculosis, or PPD-positive donor. An additional 14 transplant recipients were treated in accordance with this policy without complications or subsequent mycobacterial infections (32-month average follow-up). Despite the low Incidence of mycobacterial Infection in this series, the potential lethality and morbidity mandate constant vigilance.

(Arch Surg 1983;118:356-359)

Author Affiliations
From the Departments of Medicine (Dr Grossman) and Surgery (Drs Dafoe, Rabin, Naji, Barker, and Perloff), University of Pennsylvania School of Medicine, Philadelphia, and the Department of Surgery, UMDNJ/ Rutgers Medical School, Camden, NJ (Dr Spence).

Footnotes
Accepted for publication Oct 18, 1982.

Read before the second annual meeting of the Surgical Infection Society, Boston, April 20, 1982.

Reprint requests to Department of Surgery, UMDNJ/Rutgers Medical School, 300 Broadway, Eighth Floor, Camden, NJ 08103 (Dr Spence).

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