VISCERAL LEISHMANIASIS (KALA-AZAR) IN TRANSPLANT RECIPIENTS - CASE-REPORT AND REVIEW

Background. In endemic areas, visceral leishmaniasis has been identifi ed as an opportunistic infection in patients with derangements in thei r cellular immune system. Methods. We report a renal transplant patien t with visceral leishmaniasis. We also reviewed the previously publish ed cases of 17 organ transplant recipients with this parasitic disease . Results. Visceral leishmaniasis occurred a median time of 8 months a fter transplantation, and the clinical picture was characterized by fe ver, splenomegaly, and blood cytopenias, Leishmaniae were detected in bone marrow in 16 of 18 patients and diagnostic serology results were found in 8 of 10 tested patients. Pentavalent antimonials were used to treat 1.6 patients, five of which developed pancreatitis. Five of 18 patients died, including two untreated patients. Relapses of visceral leishmaniasis occurred in 4 of 13 survivors. Conclusions. In endemic a reas, visceral leishmaniasis may complicate the clinical course of org an transplantation and can have fatal consequences, particularly when untreated.