Fatal Hemorrhagic Intracranial TB in a Renal Transplant Recipient despite INH Prophylaxis

A 50-year-old ESRD who received LUR renal graft abroad. Since transplanted, he remained dependent on hemodialysis. The patient received steroid pulse therapy twice for rejecrion. Nonspecific bilateral lung infiltrate were noted on admission CXR, which stimulated the search for TB. The patient suddenly lost consciousness during his hospital stay. Intracranial hemorrhage was drained and tissue staining revealed heavy loads of tuberculus (TB) bacilli. The patient died two weeks later from septic shock with multi-organ failure.