RESUMEN
A 44-year-old Pakistani lady with end-stage renal disease secondary to rapidly proliferative glomerulonephritis underwent successful renal transplantation. Three years later, she was referred to the surgeon with an abscess in the axillary region at the site of a previous arterio-venous (AV) graft. She underwent repeated incision and drainage of the abscess, which was constantly recurring. Nine months later, she presented with a tender swelling at the site of the AV graft with purulent discharge. The graft was removed; culture and histology confirmed the presence of tuberculosis (TB). This patient presents a rare case of TB infection in the AV graft.
Asunto(s)
Absceso/microbiología , Derivación Arteriovenosa Quirúrgica/efectos adversos , Vena Axilar/cirugía , Implantación de Prótesis Vascular/efectos adversos , Prótesis Vascular/efectos adversos , Arteria Braquial/cirugía , Trasplante de Riñón/efectos adversos , Infecciones Relacionadas con Prótesis/microbiología , Tuberculosis/microbiología , Absceso/diagnóstico , Absceso/terapia , Adulto , Antituberculosos/uso terapéutico , Derivación Arteriovenosa Quirúrgica/instrumentación , Implantación de Prótesis Vascular/instrumentación , Remoción de Dispositivos , Drenaje , Femenino , Humanos , Infecciones Relacionadas con Prótesis/diagnóstico , Infecciones Relacionadas con Prótesis/terapia , Diálisis Renal , Reoperación , Resultado del Tratamiento , Tuberculosis/diagnóstico , Tuberculosis/terapiaRESUMEN
Features suggestive of thrombotic thrombocytopenic purpura (TTP) are known to occur in patients with systemic lupus erythematosus (SLE). We report a patient who had TTP which resolved with plasma exchange and immunosuppression, but presented three years later with features of SLE. The diagnosis satisfied all the required criteria in both instances. The interrelationship between the two conditions is discussed.