Visceral leishmaniasis in organ transplant recipients: 11 new cases and a review of the literature.
Eleven new cases of visceral leishmaniasis (VL) are reported in organ transplant patients in France. The epidemiological, clinical, biological, diagnostic and therapeutic features are reviewed, based on these cases and 46 cases reported in the literature. VL was most commonly associated with renal transplantation (77% of the cases). Most patients were from Southern European countries. The main clinical symptom was fever. Leucopoenia and anaemia were the most frequent haematological disorders. Diagnosis was by direct finding of the parasite in smears of bone marrow (85.2%) or, by positive serology (90.9%). Without antileishmanial treatment, VL in transplant recipients was fatal. Treatment using either antimonials or amphotericine B gave similar cure rates of around 80% of the cases. But toxicity was higher for antimonials. Relapses occurred in 14.3%.
Basset
Didier
D
Laboratoire de Parasitologie-Mycologie and Centre National de Référence des Leishmania, CHU de Montpellier, 163, rue Auguste-Broussonet, 34090 Montpellier, France.
Faraut
Françoise
F
Marty
Pierre
P
Dereure
Jacques
J
Rosenthal
Eric
E
Mary
Charles
C
Pratlong
Francine
F
Lachaud
Laurence
L
Bastien
Patrick
P
Dedet
Jean-Pierre
JP
D000818:Animals; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D001853:Bone Marrow / Q000469:parasitology; D006801:Humans; D007891:Leishmania / Q000302:isolation & purification; D007898:Leishmaniasis, Visceral / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D016377:Organ Transplantation / Q000009:adverse effects*; D011183:Postoperative Complications
D000981:Antiprotozoal Agents