RESUMEN
Tuberculosis is of particular concern in lung transplant recipients. We present the case of a patient who received a double lung transplant from a deceased donor from Mexico and developed disseminated tuberculosis 60 days post-transplant manifested as tenosynovitis, liver abscesses, and subcutaneous nodules with no definitive lung allograft involvement. The recipient did not have evidence of tuberculosis on explanted lungs, had a negative interferon gamma release assay pre-transplant, and did not have risk factors for this infection. Mycobacterium tuberculosis should remain in the differential diagnosis of early post-transplant infections with atypical presentations, evidence of dissemination, or lack of improvement with appropriate antimicrobial coverage, even in the absence of typical lung findings.
RESUMEN
We report two immigrants from Cuba seen in a US travel clinic with a confirmed diagnosis of cutaneous leishmaniasis in whom we also suspected malaria co-infection. Both individuals likely acquired leishmaniasis in the Darien Gap region of Panama during their migratory path to the United States. As part of their clinical workup to rule out malaria, a rapid malaria antigen testing for P. falciparum was obtained and reported positive in both patients, However, both a qualitative reverse transcription-polymerase chain reaction (RT-PCR) for Plasmodium falciparum in blood and repeated thick-and-thin smear direct microscopy were negative in both, deeming the rapid malaria test as a false-positive. Thus, confirmation of malaria in travelers requires thick-and-thin film microscopy. Clinicians should be aware of the growing recognition of the possibility of false-positive malaria rapid diagnostic tests in those with some forms of leishmaniasis.