Visceral leishmaniasis after orthotopic liver transplantation: impact of persistent splenomegaly

Abstract

Visceral leishmaniasis was observed in a 50-year-old female liver transplant recipient 1 year following transplantation. Signs of active infection were low-grade fever, pancytopenia, persistent splenomegaly, positive cultures for leishmania in liver and bone marrow biopsy specimens, and newly positive leishmania serology. Following sequential therapy with pentavalent antimony and amphotericin B, blood values improved massively, bone marrow cultures became negative, and leishmania serology decreased. Secondary prophylaxis with fluconazole was instituted and the patient remains without signs of active infection 1 year after successful therapy.

Visceral Leishmaniasis in a Renal Transplant Recipient

“…In our case and the one of Shamar et al [3], we were able to find 17 cases of VL in solid organ recipients [3][4][5]. Except for 1 liver transplant recipient [5], all were renal transplant recipients.…”

“…Except for 1 liver transplant recipient [5], all were renal transplant recipients. The majority of the patients lived or had traveled to areas where VL is endemic, including Southern Europe, Malta, the Near East and India.…”

Recurrent cytomegalovirus disease, visceral leishmaniosis, and Legionella pneumonia after liver transplantation: a case report

“…Visceral leishmaniosis after organ transplantation has been described on some 26 occasions, mostly in renal patients 8,9 and, to the best of our knowledge, ours is only the third case following liver grafting. 10,11 The mortality is high, as Berenguer et al reported five deaths out of 18 patients.…”

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

“…Over 60 cases of VL in SOT recipients have been described (14,27,136,164,176,184,251,274,319,342), with the majority occurring in renal transplant patients. This correlates with the increased number of renal transplants performed compared to other organs.…”