Mycobacterium tuberculosis

DONOR: 31-year-old male with sepsis and pneumonia. He died from intracerebral bleeding. BAL was Ziehl Nielsen negative and M.tuberculosis (MTB) PCR negative, but BAL culture turned positive for MTB 1 day after organ procurement. RECIPIENT: 62 year-old male with dilated cardiomyopathy. When the donor BAL turned positive, one day after transplantation, blood cultures (BACTEC Myco/F Lytic) and tracheal aspirates for mycobacterial cultures were obtained from the recipient, and he started treatment with prophylactic isoniazid 300 mg/day; 3 weeks later recipient's blood cultures turned positive for MTB. Respiratory samples remained negative. He started antiTB treatment with streptomycin, ethambutol and levofloxacin. The recipient died 3 months after heart transplantation (massive intracerebral bleeding). He never showed signs of active tuberculosis infection; post-mortem histological examination (brain, lung, heart,kidney, pancreas) and MTB PCR of these tissues were all negative for MTB.