Leishmaniasis: a rare cause of unexplained fever in a renal graft recipient.
We report a case of visceral leishmaniasis in a 38-year-old renal transplant recipient living in an endemic country. Antimonial derivatives induced a rapid remission. A review of the literature disclosed 8 cases of this association with a fatal fulminant outcome in 5 cases. We suggest that the specific immunosuppression used in renal transplant patients might facilitate the development of a dormant infection and in these patients the misleading presentation may delay the diagnosis. Moreover special caution with treatment of leishmaniasis must be taken in renal transplant because of possible interactions between antimony compounds and ciclosporin metabolites. In renal transplant patients living in endemic countries, visceral leishmaniasis should be kept in mind as a potential cause of unexplained long-standing fever and considered as an opportunistic infection.
Moulin
B
B
Department of Nephrology, Hôpital de la Conception, Marseille, France.
Ollier
J
J
Bouchouareb
D
D
Purgus
R
R
Olmer
M
M
D000328:Adult; D000493:Allopurinol / Q000627:therapeutic use; D000818:Animals; D000965:Antimony / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D006084:Graft Rejection; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D016030:Kidney Transplantation / Q000009:adverse effects*; D007893:Leishmania donovani / Q000302:isolation & purification; D007898:Leishmaniasis, Visceral / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D008536:Meglumine / Q000627:therapeutic use; D000077485:Meglumine Antimoniate; D008775:Methylprednisolone / Q000627:therapeutic use; D016853:Muromonab-CD3 / Q000627:therapeutic use; D009942:Organometallic Compounds / Q000627:therapeutic use
D000981:Antiprotozoal Agents; D016853:Muromonab-CD3; D009942:Organometallic Compounds; D000493:Allopurinol; D008536:Meglumine; D000077485:Meglumine Antimoniate; D000965:Antimony; D008775:Methylprednisolone