tetano
Editor, Senior Moderator
J Clin Exp Hepatol
. 2021 Dec 8.
doi: 10.1016/j.jceh.2021.12.002. Online ahead of print.
Invasive Pulmonary Aspergillosis and Tuberculosis complicated by Hemophagocytic Lymphohistiocytosis - Sequelae of COVID-19 in a Liver Transplant Recipient
Akash Gandotra[SUP] 1 [/SUP], Rohit Mehtani[SUP] 1 [/SUP], Madhumita Premkumar[SUP] 1 [/SUP], Ajay Duseja[SUP] 1 [/SUP], Arka De[SUP] 1 [/SUP], Nabhajit Mallik[SUP] 2 [/SUP], S Durgadevi[SUP] 2 [/SUP], Ashim Das[SUP] 3 [/SUP], Naveen Kalra[SUP] 4 [/SUP]
Affiliations
Abstract
Liver transplant recipients are at an increased risk of opportunistic infections due to use of immunosuppression. Coronavirus disease of 2019 (COVID-19) increases the risk of these infections further due to associated immune dysfunction and use of high dose steroids. We present a case of liver transplant recipient who developed disseminated tuberculosis and invasive pulmonary aspergillosis complicated by acquired hemophagocytic lymphohistiocytosis after recovering from severe COVID-19.
Keywords: AFB, Acid fast bacilli; AKI, Acute kidney Injury; ATT, Anti-tubercular therapy; BDG, Beta-D Glucan; COVID-19; COVID-19, Coronavirus disease of 2019; DEB-TACE, Drug eluting bead trans-arterial chemoembolization; GM, Galactomannan; HCC, Hepatocellular Carcinoma; HLH, Hemophagocytic Lymphohistiocytosis; HRCT, High resolution computed tomography; IDSA, Infectious Diseases Society of America; IPA, Invasive pulmonary aspergillosis; IVIg, Intravenous immunoglobulin; Invasive aspergillosis; Lenvatinib; Liver transplant; NODAT, New onset diabetes after transplant; PAS, Periodic acid Schiff; RT-PCR, Reverse transcriptase polymerase chain reaction; SARS-CoV-2; SARS-CoV-2, Severe acute respiratory syndrome corona virus 2; disseminated tuberculosis; hemophagocytic lymphohistiocytosis; hepatocellular carcinoma; mRECIST, modified response evaluation criteria in solid tumors; sHLH, Secondary hemophagocytic lymphohistiocytosis.
. 2021 Dec 8.
doi: 10.1016/j.jceh.2021.12.002. Online ahead of print.
Invasive Pulmonary Aspergillosis and Tuberculosis complicated by Hemophagocytic Lymphohistiocytosis - Sequelae of COVID-19 in a Liver Transplant Recipient
Akash Gandotra[SUP] 1 [/SUP], Rohit Mehtani[SUP] 1 [/SUP], Madhumita Premkumar[SUP] 1 [/SUP], Ajay Duseja[SUP] 1 [/SUP], Arka De[SUP] 1 [/SUP], Nabhajit Mallik[SUP] 2 [/SUP], S Durgadevi[SUP] 2 [/SUP], Ashim Das[SUP] 3 [/SUP], Naveen Kalra[SUP] 4 [/SUP]
Affiliations
- PMID: 34898957
- PMCID: PMC8653520
- DOI: 10.1016/j.jceh.2021.12.002
Abstract
Liver transplant recipients are at an increased risk of opportunistic infections due to use of immunosuppression. Coronavirus disease of 2019 (COVID-19) increases the risk of these infections further due to associated immune dysfunction and use of high dose steroids. We present a case of liver transplant recipient who developed disseminated tuberculosis and invasive pulmonary aspergillosis complicated by acquired hemophagocytic lymphohistiocytosis after recovering from severe COVID-19.
Keywords: AFB, Acid fast bacilli; AKI, Acute kidney Injury; ATT, Anti-tubercular therapy; BDG, Beta-D Glucan; COVID-19; COVID-19, Coronavirus disease of 2019; DEB-TACE, Drug eluting bead trans-arterial chemoembolization; GM, Galactomannan; HCC, Hepatocellular Carcinoma; HLH, Hemophagocytic Lymphohistiocytosis; HRCT, High resolution computed tomography; IDSA, Infectious Diseases Society of America; IPA, Invasive pulmonary aspergillosis; IVIg, Intravenous immunoglobulin; Invasive aspergillosis; Lenvatinib; Liver transplant; NODAT, New onset diabetes after transplant; PAS, Periodic acid Schiff; RT-PCR, Reverse transcriptase polymerase chain reaction; SARS-CoV-2; SARS-CoV-2, Severe acute respiratory syndrome corona virus 2; disseminated tuberculosis; hemophagocytic lymphohistiocytosis; hepatocellular carcinoma; mRECIST, modified response evaluation criteria in solid tumors; sHLH, Secondary hemophagocytic lymphohistiocytosis.