title: Atypical presentation of cutaneous leishmaniasis in a renal transplant recipient successfully treated with allopurinol and fluconazole.
abstract: Leishmaniasis is a zoonotic infection acquired through the bite of a female sandfly, which introduces the amastigotes of Leishmania into the bloodstream. Cutaneous leishmaniasis is rare after solid organ transplantation. Its diagnosis is difficult in immunosuppressed patients. We report a case of isolated cutaneous leishmaniasis in a renal transplant patient resident in an endemic area. The patient was successfully treated with allopurinol and fluconazole and has remained relapse-free for 44 months. The diagnosis of cutaneous leishmaniasis must be considered in immunosuppressed patients living in endemic areas. Our report shows that cutaneous leishmaniasis may complicate the clinical course of kidney transplant recipients and its presentation can be atypical. Conventional treatment with pen.tavalent antimonial agents can cause many side effects; of particular concern in renal transplant pa.tients are pancreatitis and nephrotoxicity. These latter may be avoided by using a combination of allopurinol and fluconazole.
authors: Department of Nephrology, Hedi Chaker Hospital, Sfax University, Tunisia. soumayagfr@yahoo.fr
authors: Soumaya
authors: S
authors: Yaich
authors: Khaled
authors: K
authors: Charfeddine
authors: Abderrahmen
authors: A
authors: Masmoudi
authors: Mondher
authors: M
authors: Masmoudi
authors: Sawssen
authors: S
authors: Zaghdhane
authors: Hamida
authors: H
authors: Turki
authors: Jamil
authors: J
authors: Hachicha
mesh_terms: D000328:Adult; D000493:Allopurinol / Q000627:therapeutic use*; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use*; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation; D016773:Leishmaniasis, Cutaneous / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000276:immunology; D011183:Postoperative Complications / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology
chemical_list: D000981:Antiprotozoal Agents; D000493:Allopurinol; D015725:Fluconazole