Nontuberculous Mycobacterial Graft Pyelonephritis in a Post-Renal Transplant Recipient

Nontuberculous mycobacterial (NTM) infections pose significant challenges in renal transplant recipients. We present a case of Mycobacterium chelonae graft pyelonephritis in a 19-year-old female post-ABO incompatible renal transplantation. The patient presented with a subcutaneous abscess over the graft site, which revealed pyelonephritis with perinephric collection. Persistent symptoms prompted the identification of M. chelonae. Management included tailored antimicrobial therapy and surgical debridement, resulting in full recovery and improved graft function. This case highlights the importance of considering NTM infections in transplant recipients with atypical presentations and emphasizes the need for species identification and susceptibility testing to guide effective treatment.