Mirzabeigi Marjan, Farooq Uzma, Baraniak Sean, Dowdy Lorraine, Ciancio Gaetano, Vincek Vladimir
Department of Pathology, School of Medicine, University of Miami, Miami, FL, USA.
J Cutan Pathol. 2006 Oct;33(10):701-4. doi: 10.1111/j.1600-0560.2006.00532.x.
Leishmaniasis is an infection caused by a protozoan parasite belonging to genus Leishmania and transmitted by the Phlebotomus sandfly. Clinical presentations of infection include visceral, cutaneous, and mucocutaneous forms. Leishmaniasis is endemic in Africa, Asia, Europe, South America, and southern part of North America. This infection is extremely rare in the US and is mostly found among travelers coming from endemic areas. Cases of cutaneous and visceral leishmaniasis have been reported in organ transplant recipients in endemic areas.
We describe a case of cutaneous leishmaniasis in a kidney transplant patient, originally from Bolivia, who resides in the area known to be non-endemic for leishmaniasis and who is known not to travel within or outside of the US after the transplantation.
Histologic examination of cutaneous lesion revealed extensive subcutaneous lymphohistiocytic inflammation with clusters of amastigote within histiocytes.
To our knowledge, this is the first case of cutaneous leishmaniasis in a kidney transplant patient residing in the US in an area known to be non-endemic for leishmaniasis, probably after reactivation of a previously dormant infection acquired outside of the US at least 9 months prior to developing clinical symptoms.
利什曼病是由利什曼原虫属的原生动物寄生虫引起的感染，通过白蛉传播。感染的临床表现包括内脏型、皮肤型和黏膜皮肤型。利什曼病在非洲、亚洲、欧洲、南美洲和北美洲南部流行。这种感染在美国极为罕见，大多见于来自流行地区的旅行者。在流行地区的器官移植受者中曾报告过皮肤型和内脏型利什曼病病例。
我们描述了一例肾移植患者的皮肤利什曼病病例，该患者原籍玻利维亚，居住在已知非利什曼病流行区，且已知移植后未在美国境内或境外旅行。
皮肤病变的组织学检查显示广泛的皮下淋巴细胞组织细胞炎症，组织细胞内有成簇的无鞭毛体。
据我们所知，这是首例居住在美国已知非利什曼病流行区的肾移植患者发生的皮肤利什曼病病例，可能是至少在出现临床症状前9个月于美国境外获得的先前潜伏感染重新激活所致。
