{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T17:58:22Z","timestamp":1777571902316,"version":"3.51.4"},"reference-count":17,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,5,6]],"date-time":"2023-05-06T00:00:00Z","timestamp":1683331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The risk of infection following kidney transplant increases substantially in the setting of hypogammaglobulinemia and T\u2010cell\u2010depleting therapy. <jats:italic>Ureaplasma<\/jats:italic> has been described to cause invasive disease in immunocompromised hosts with humoral immunodeficiency. We describe a kidney transplant recipient with history of antineutrophil cytoplasmic autoantibody (ANCA) vasculitis remotely treated with rituximab who developed <jats:italic>Ureaplasma<\/jats:italic> polyarthritis following transplant. The purpose of this report is to highlight the unique risks that kidney transplant patients face particularly if hypogammaglobulinemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Report<\/jats:title><jats:p>Patient is a 16\u2010year\u2010old female with history of granulomatosis with polyangiitis (GPA) treated with maintenance dose of rituximab 13\u2009months prior to transplant. Patient underwent deceased donor kidney transplant with thymoglobulin induction. IgG was 332\u2009mg\/dL and CD20 was zero at the time of transplant. One month posttransplant, the patient developed polyarticular arthritis without fever, pyuria, or evidence of GPA reactivation. MRI had diffuse tenosynovitis, myositis, fasciitis, cellulitis, and effusions of three involved joints. Bacterial, fungal, and AFB cultures remained negative, but 16\u2009s ribosomal PCR testing from joint aspirates detected <jats:italic>Ureaplasma parvum<\/jats:italic>. The patient was treated with levofloxacin for 12\u2009weeks with the resolution of symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:italic>Ureaplasma<\/jats:italic> infection is an under\u2010recognized pathogen in kidney transplant patients. A high index of clinical suspicion should be employed to identify <jats:italic>Ureaplasma<\/jats:italic> infection, especially in those with secondary hypogammaglobulinemia, as this is often missed due to its lack of growth on standard media and the need for molecular testing. In patients with prior B\u2010cell depletion, routine monitoring for B\u2010cell recovery to identify risk factors for opportunistic infections is indicated.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14538","type":"journal-article","created":{"date-parts":[[2023,5,7]],"date-time":"2023-05-07T06:44:10Z","timestamp":1683441850000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Disseminated <i>Ureaplasma<\/i> polyarthritis in a renal transplant recipient"],"prefix":"10.1111","volume":"27","author":[{"given":"Samantha","family":"Schwartz","sequence":"first","affiliation":[{"name":"Pediatric Residency Program Helen DeVos Children's Hospital\/Michigan State University  Grand Rapids Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aileen","family":"Aldrich","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Helen DeVos Children's Hospital  Grand Rapids Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Kessler","sequence":"additional","affiliation":[{"name":"Pediatric Rheumatology Helen DeVos Children's Hospital  Grand Rapids Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khalid","family":"Abulaban","sequence":"additional","affiliation":[{"name":"Pediatric Rheumatology Helen DeVos Children's Hospital  Grand Rapids Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8601-9479","authenticated-orcid":false,"given":"Julia M.","family":"Steinke","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology and Transplant Helen DeVos Children's Hospital  Grand Rapids Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,5,6]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofz399"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000495081"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e318199d19a"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmii.2017.05.004"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/144.2.123"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-021-06733-0"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2020-236396"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2017.07.007"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2020-237916"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13032"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.01897-06"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12937"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365540600675734"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra064928"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1128\/aac.00671-16"},{"issue":"2","key":"e_1_2_6_17_1","first-page":"366","article-title":"Septic arthritis due to dual infection with mycoplasma hominis and Ureaplasma urealyticum","volume":"15","author":"Burdge DR","year":"1988","journal-title":"J Rheumatol"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2022.01.025"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.14538","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T13:02:10Z","timestamp":1725627730000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.14538"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,6]]},"references-count":17,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1111\/petr.14538"],"URL":"https:\/\/doi.org\/10.1111\/petr.14538","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"value":"1397-3142","type":"print"},{"value":"1399-3046","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,6]]},"assertion":[{"value":"2022-11-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14538"}}