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BMC Infect Dis ; 15: 96, 2015 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-25877483

RESUMO

BACKGROUND: Visceral leishmaniasis is a disease caused by the protozoan Leishmania sp. and is transmitted by Lutzomyia longipalpis (sand fly). In renal transplant recipients, visceral leishmaniasis causes severe damage to the liver, spleen, and hematopoietic system, as well as poor outcomes for patients with transplanted kidneys. This study describes the largest series of cases of visceral leishmaniasis in renal transplant recipients, providing important information about the diagnostic routines and therapeutic strategies in this patient population. METHODS: A retrospective, descriptive study was performed to analyze the distribution and evaluate the extent of the epidemiologic, clinical, diagnostic and therapeutic aspects of 30 renal transplant recipients from endemic regions who presented with visceral leishmaniasis in the post-transplantation period. RESULTS: In this study, visceral leishmaniasis was more frequent in men (80%). The mean age of presentation was 40 ± 10.5 years. The majority of patients worked in urban areas (66.7%), cohabitated with domestic animals (90%), and were from low-income households. In 73.3% of cases, diagnosis was made by direct isolation of Leishmania forms. Patients were treated with liposomal amphotericin, resulting in a high degree of disease remission (80%). CONCLUSIONS: This study describes the largest series of visceral leishmaniasis in renal transplant recipients and expands clinical-epidemiological knowledge for transplantation teams to perform adequate disease management for this specific patient population.


Assuntos
Anfotericina B/uso terapêutico , Antiprotozoários/uso terapêutico , Hospedeiro Imunocomprometido , Imunossupressores/efeitos adversos , Transplante de Rim , Leishmaniose Visceral/epidemiologia , Adulto , Distribuição por Idade , Animais , Animais Domésticos , Feminino , Humanos , Nefropatias/induzido quimicamente , Nefropatias/diagnóstico , Nefropatias/tratamento farmacológico , Nefropatias/epidemiologia , Leishmania/isolamento & purificação , Leishmaniose Visceral/induzido quimicamente , Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/tratamento farmacológico , Hepatopatias/diagnóstico , Hepatopatias/tratamento farmacológico , Hepatopatias/epidemiologia , Hepatopatias/etiologia , Masculino , Pessoa de Meia-Idade , Características de Residência , Estudos Retrospectivos , Distribuição por Sexo , Esplenopatias/induzido quimicamente , Esplenopatias/diagnóstico , Esplenopatias/tratamento farmacológico , Esplenopatias/epidemiologia , Transplantados
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