# Tuberculous Retroperitoneal Lymphadenitis After Kidney Transplantation That Was Difficult to Diagnose and Treat: A Case Report

## TL;DR

A kidney transplant recipient developed a rare and challenging case of tuberculosis in the retroperitoneal lymph nodes, requiring multiple treatments for recovery.

## Contribution

This case report highlights the diagnostic and therapeutic challenges of tuberculous retroperitoneal lymphadenitis after kidney transplantation.

## Key findings

- Tuberculous retroperitoneal lymphadenitis was diagnosed via PCR and smear tests in drainage fluid.
- The patient required open drainage and long-term antituberculosis treatment for clinical improvement.
- The patient remained in remission for 1 year after treatment discontinuation.

## Abstract

We present a rare case of tuberculous retroperitoneal lymphadenitis after kidney transplantation that was difficult to diagnose and treat.

A 52‐year‐old man who received a kidney transplantation from his wife presented with right lower quadrant pain. Computed tomography (CT) scan revealed multiple enlarged retroperitoneal lymph nodes, which later formed abscesses. From the positive
Mycobacterium tuberculosis
polymerase chain reaction test and smear in the drainage fluid, he was diagnosed with tuberculosis. Despite treatment with antituberculosis drugs, the abscesses increased, and he was treated by open drainage. He showed gradual clinical improvement and was discharged 9 weeks after hospitalization. While an abscess around the pancreatic tail remained, he was in remission, and antituberculosis drugs were terminated 404 days after initiation. He has gone 1 year without recurrence.

Tuberculous lymphadenitis after kidney transplantation is a rare condition but should be kept in mind for accurate diagnosis.