Elderly kidney transplant recipient with intermittent fever: a case report of leishmaniasis with acute kidney injury during liposomal amphotericin B therapy.
Transplant Proc
; 46(7): 2365-7, 2014 Sep.
Article
in En
| MEDLINE
| ID: mdl-25242789
ABSTRACT
We present a case report of visceral leishmaniasis in an elderly kidney transplant recipient (age, 73 years) with high intermittent fever in the 2 months before admission. Symptoms started 16 years after transplant. The patient received appropriate treatment with liposomal amphotericin and experienced transient increases in serum creatinine levels. Progression to dialysis was avoided with short duration of therapy (5 consecutive days, plus 1 more dose 1 week apart, a schedule alternative to 15-21 days [supported by the literature]) and a temporary reduction in tacrolimus exposure. After 4 months, recurrence of symptoms without other explanation required a second bone marrow aspirate; it revealed the persistence of amastigote forms. Visceral leishmaniasis is a potentially life-threatening infection; to the best of our knowledge, this is the oldest transplanted patient with a case of leishmaniasis described in the literature.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Amphotericin B
/
Kidney Transplantation
/
Acute Kidney Injury
/
Leishmaniasis, Visceral
/
Antiprotozoal Agents
Type of study:
Etiology_studies
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
En
Journal:
Transplant Proc
Year:
2014
Document type:
Article
Affiliation country:
Italia