An unusual case of late, isolated involvement of renal allograft with tuberculosis

Tuberculosis is endemic in India, with a prevalence of 8%–13% in kidney transplant patients. Atypical presentations have been described in immunocompromised individuals, and we present an unusual and rare case of isolated tuberculous involvement of the kidney allograft presenting 6 years posttransplant. Our patient presented with fever, poor appetite, and malaise of very short duration without ongoing weight loss; a normal urine examination as well as ultrasonography of allograft, requiring positron emission tomography-computed tomography to determine the source of infection. A vigilant approach with a high degree of suspicion in this case led to early detection and good outcomes.