Case Report

Specific meningoencephalitis in patients with transplanted kidney

Mithat Tabakovic*, Senaid Trnacevic and Maida Dugonjic Taletovic

Published: 17 June, 2020 | Volume 4 - Issue 2 | Pages: 024-026

We described a case of specific (tuberculous) encephalitis in a patient after kidney transplantation. Immunosuppressive therapy, continuously required in post-tranplant period, may cause various complications, such as infections. Specific 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 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 significant neurological deficit and expressed meningeal signs. In cerebrospinal fluid we found lymphocytosis, elevated proteins and positive micobacterium tuberculosis antibodies (Hexagon method) and we suspected to specific etiology of meningitis. Performed computed tomography (CT) scan of the brain with contrast confirmed the expected finding.

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.

Read Full Article HTML DOI: 10.29328/journal.jcn.1001055 Cite this Article Read Full Article PDF


Meningoencephalitis; Diabetes mellitus; Kidney transplantation; Antituberculous drug; Immunosuppression


  1. Cohen J, Hopkin J, Kurtz J. Infectious complications after renal transplantation. In: Morris PJ (ed). Kidney Transplantation; Principles and Practice. WB Saunders Company, Philadelphia, London, New York, Toronto. 2002; 468-490.
  2. Živčić-Ćosić S, Trobonjača Z, Rački S. Imunosupresivno liječenje kod presađivanja bubrega. Medicina. 2010; 4: 413-23.
  3. Campbell PM. Pathology of acute rejection in the renal allograft. ASHI quaterly. Third quarter. New Jersey: ASHI. 2004: 86.
  4. Ležaić V, Radivojević D, Blagojević R, Đukanović LJ. Infection of central nervous system after kidney transplantation. Transplant Infect Dis 2002; 4: 167-168.
  5. Kidney Disease. Improving Global Outcomes (KDIGO) Transplant Work Group. KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant. 2009; 9 (Suppl 3): S1-155. PubMed: https://pubmed.ncbi.nlm.nih.gov/19845597/
  6. Brennan DC, Bohl D. Infectious complications in renal transplant recipients. In: Malluche HH, Sawaya BP, Hakim RM, Sayegh MH (eds). Clinical nephrology, dialysis and transplantation. 2004; 1-34.
  7. Randhawa P, Brennan DC. BK virus infection in transplant recipients: An overview and update. Am J Transplant. 2006; 6: 2000-2005. PubMed: https://pubmed.ncbi.nlm.nih.gov/16771813
  8. Ležaić V, Radivojević R, Radosavljević R, Blagojević R, Simić S, et al. Does tuberculosis after kidney transplantation follows the trend of tuberculosis in general population? Renal Failure. 2001; 23: 97-106. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11256535
  9. Singh N, Paterson DL. Mycobacterium tuberculosis infection in solid organ transplant recipients: impact and implications for menagement. Clin Infect Dis. 2008; 27: 1266-1277.
  10. Morath C, Schmied B, Mehrabi A, Weitz J, Schmidt J, et al. Simultaneous pancreas-kidney transplantation in type 1 diabetes. Clin Transplant. 2009; 23 Suppl 21: 115-20. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/19930324
  11. Joyce AT, Iacoviello JM, Nag S. End-stage renal disease-associated managed care costs among patients with and without diabetes. Diabetes Care. 2004; 27: 2829-2835. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/15562193

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More