Non-typhoid Salmonella septicemia and visceral leishmaniasis in a renal transplant patient.
BACKGROUND
We report on a renal transplant patient with recurrent attacks of fever, in which Salmonella septicemia as well as visceral leishmaniasis were diagnosed.


METHODS
The patient was a 62-year-old man with diabetic nephropathy and a living related kidney transplantation.


RESULTS
Nearly 2 years after the transplantation, the patient developed recurrent attacks of fever, which were initially diagnosed as non-typhoid salmonellosis and improved after treatment. Three months later, he had relapses of fever. As the patient developed pancytopenia, a bone marrow aspiration was done, showing Leishmania parasites. The patient responded well to treatment with sodium stibogluconate.


CONCLUSIONS
A high index of suspicion, together with better diagnostic assays to detect visceral leishmaniasis, is warranted in the diagnostic work-up of any fever of unknown origin in immunocompromised patients, especially in endemic areas.
Department of Nephrology and Dialysis, Al Hada Armed Forces Hospital, Taif, Saudi Arabia.
M M
MM
Hussein
J M
JM
Mooij
H M
HM
Roujouleh
O A
OA
Hamour
H
H
Felemban
D016470:Bacteremia / Q000175:diagnosis / Q000382:microbiology*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D007898:Leishmaniasis, Visceral / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012475:Salmonella / Q000302:isolation & purification*; D012480:Salmonella Infections / Q000175:diagnosis / Q000382:microbiology*