{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T23:45:45Z","timestamp":1768693545247,"version":"3.49.0"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,6,13]],"date-time":"2020-06-13T00:00:00Z","timestamp":1592006400000},"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":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Noncirrhotic hyperammonemia (NCH) is a rare but often fatal complication of solid organ transplantation. We present a case wherein an infectious cause of NCH was suspected following kidney transplantation (KT) and the patient was promptly started on empirical antibiotic treatment which proved to be lifesaving. A 56\u2010year\u2010old Chinese woman with a past medical history of end\u2010stage renal disease secondary to ischemic nephropathy and cerebrovascular accident received a kidney from a 52\u2010year\u2010old brain\u2010dead donor with a Kidney Donor Profile Index score of 70%. She experienced immediate graft function and was discharged on post\u2010operative day (POD) 4. On POD 10, she presented with a fever, acute onset of confusion, and abdominal pain. Her mental status deteriorated and required emergent intubation. Empiric broad\u2010spectrum antibiotics were initiated. On hospital day 3, a serum ammonia was 889\u00a0\u03bcmol\/L (normal &lt;53\u00a0\u03bcmol\/L). A urine sample was sent for <jats:italic>Ureaplasma<\/jats:italic> polymerase chain reaction (PCR) testing, and moxifloxacin and doxycycline were empirically started. Her ammonia rapidly normalized, and her mental status improved 48\u00a0hours after antibiotic initiation. She was extubated 5\u00a0days into treatment and was discharged after an 11\u2010day hospitalization. Following discharge, her urine test resulted positive for <jats:italic>Ureaplasma parvum<\/jats:italic> or <jats:italic>Ureaplasma urealyticum<\/jats:italic> DNA detection with the 16S rRNA gene amplification probe. Mental status changes and hyperammonemia in the first 30\u00a0days post\u2010KT should raise suspicion for NCH, and prompt empiric treatment with antimicrobials covering <jats:italic>Ureaplasma<\/jats:italic> and <jats:italic>Mycoplasma<\/jats:italic> should be considered.<\/jats:p>","DOI":"10.1111\/tid.13332","type":"journal-article","created":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T22:01:29Z","timestamp":1589925689000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Successful management of noncirrhotic hyperammonemia syndrome after kidney transplantation from putative <i>Ureaplasma<\/i> infection"],"prefix":"10.1111","volume":"22","author":[{"given":"Faiqa","family":"Cheema","sequence":"first","affiliation":[{"name":"Hartford Hospital Transplant Program Hartford CT USA"},{"name":"University of Connecticut School of Medicine Farmington CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0106-9822","authenticated-orcid":false,"given":"Heather L.","family":"Kutzler","sequence":"additional","affiliation":[{"name":"Hartford Hospital Transplant Program Hartford CT USA"},{"name":"Department of Pharmacy Hartford Hospital Hartford CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayokunle S.","family":"Olowofela","sequence":"additional","affiliation":[{"name":"University of Minnesota Medical School Minneapolis MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bejon T.","family":"Maneckshana","sequence":"additional","affiliation":[{"name":"Hartford Hospital Transplant Program Hartford CT USA"},{"name":"University of Connecticut School of Medicine Farmington CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5076-0938","authenticated-orcid":false,"given":"Caroline","family":"Rochon","sequence":"additional","affiliation":[{"name":"Hartford Hospital Transplant Program Hartford CT USA"},{"name":"University of Connecticut School of Medicine Farmington CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia A.","family":"Sheiner","sequence":"additional","affiliation":[{"name":"Hartford Hospital Transplant Program Hartford CT USA"},{"name":"University of Connecticut School of Medicine Farmington CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8338-3216","authenticated-orcid":false,"given":"Oscar K.","family":"Serrano","sequence":"additional","affiliation":[{"name":"Hartford Hospital Transplant Program Hartford CT USA"},{"name":"University of Connecticut School of Medicine Farmington CT 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