Reactivation of dormant cutaneous Leishmania infection in a kidney transplant patient.
BACKGROUND
Leishmaniasis is an infection caused by a protozoan parasite belonging to genus Leishmania and transmitted by the Phlebotomus sandfly. Clinical presentations of infection include visceral, cutaneous, and mucocutaneous forms. Leishmaniasis is endemic in Africa, Asia, Europe, South America, and southern part of North America. This infection is extremely rare in the US and is mostly found among travelers coming from endemic areas. Cases of cutaneous and visceral leishmaniasis have been reported in organ transplant recipients in endemic areas.


METHODS
We describe a case of cutaneous leishmaniasis in a kidney transplant patient, originally from Bolivia, who resides in the area known to be non-endemic for leishmaniasis and who is known not to travel within or outside of the US after the transplantation.


RESULTS
Histologic examination of cutaneous lesion revealed extensive subcutaneous lymphohistiocytic inflammation with clusters of amastigote within histiocytes.


CONCLUSIONS
To our knowledge, this is the first case of cutaneous leishmaniasis in a kidney transplant patient residing in the US in an area known to be non-endemic for leishmaniasis, probably after reactivation of a previously dormant infection acquired outside of the US at least 9 months prior to developing clinical symptoms.
Mirzabeigi
Marjan
M
Department of Pathology, School of Medicine, University of Miami, Miami, FL, USA.
Farooq
Uzma
U
Baraniak
Sean
S
Dowdy
Lorraine
L
Ciancio
Gaetano
G
Vincek
Vladimir
V
D000666:Amphotericin B / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology*; D016773:Leishmaniasis, Cutaneous / Q000150:complications / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D008875:Middle Aged; D009894:Opportunistic Infections / Q000150:complications / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D012874:Skin Diseases, Infectious / Q000150:complications / Q000188:drug therapy / Q000276:immunology / Q000473:pathology
D000981:Antiprotozoal Agents; D007166:Immunosuppressive Agents; D000666:Amphotericin B