Mycobacterium avium-intracellulare-associated acute interstitial nephritis: a rare cause of renal allograft dysfunction.

Nontuberculous mycobacterium (NTM) infections are unusual in the renal transplant population. We present a case of disseminated Mycobacterium avium-intracellulare in a renal transplant recipient who was negative for human immunodeficiency virus infection. Our patient developed renal allograft dysfunction in the setting of disseminated disease and reduced immunosuppression. Transplant biopsy showed acute interstitial nephritis with granulomas and acid-fast bacilli. Acute renal failure resolved completely with further reductions in immunosuppression and anti-mycobacterial therapy. Our patient demonstrates the challenges in diagnosis and treatment of this rare infectious complication.