Case report of intestinal tuberculosis 6 years after simultaneous pancreas and kidney transplant

Tuberculosis (TB) is often difficult to diagnose in immunocompromised patients and occurs 20 to 74 times more frequently in recipients of solid organ transplants than in the general population. We present the case of a 40-year-old female immigrant from Mexico previously treated for latent TB who underwent a simultaneous pancreas and kidney transplant. She experienced 3 episodes of rejection and then presented with 4 months of nonspecific abdominal pain. She was ultimately diagnosed with disseminated TB presenting with intestinal perforation and pulmonary involvement. This case illustrates the need for clinicians to maintain a high index of suspicion for TB in transplant recipients, especially those previously treated for TB or rejection.