Harzallah Kais, Belhadj Raoudha, Jemli Boutheina, Haloues Mondher, Berraies Naoufel, Gargouri Saadia, Hmida Jalel, Battikh Riadh, Manaa Jamel
Unity of Organ Transplantation, Military Hospital, Tunis, Tunisia.
Saudi J Kidney Dis Transpl. 2010 Jan;21(1):105-8.
Leishmaniasis is an infection caused by a protozoan parasite belonging to the genus Leishmania and transmitted by the Phlebotomus sandfly. We report a case of visceral leishmaniasis in a 49-year-old male renal transplant recipient, a resident of the western part of Tunisia, which is an endemic zone for the disease. Just before and after the transplantation, the patient resided in Tunis, which is non-endemic for leishmaniasis. Visceral leishmaniasis occurred eight years after renal transplantation, and the clinical picture was characterized by fever and pancytopenia. Leishmaniae were detected by bone marrow aspiration. Pentavalent antimonal was used for 28 days and was substituted by allopurinol (20 mg/kg per day). One year after the infection, the patient remains totally asymptomatic. Our report suggests that visceral leishmaniasis may complicate the clinical course of organ transplantation and can be fatal, particularly when untreated. Relapses may occur after completion of the apparently effective treatment. Allopurinol could be a solution to avoid these relapses.
利什曼病是由属于利什曼原虫属的原生动物寄生虫引起的一种感染，通过白蛉传播。我们报告了一例49岁男性肾移植受者的内脏利什曼病病例，该患者居住在突尼斯西部，该地是该病的流行区。在移植前后，患者居住在突尼斯，该地并非利什曼病的流行区。内脏利什曼病在肾移植八年后发生，临床表现为发热和全血细胞减少。通过骨髓穿刺检测到利什曼原虫。使用五价锑剂治疗28天，后改用别嘌呤醇（每天20mg/kg）。感染一年后，患者仍完全无症状。我们的报告表明，内脏利什曼病可能使器官移植的临床过程复杂化，并且可能是致命的，尤其是在未治疗的情况下。在看似有效的治疗完成后可能会复发。别嘌呤醇可能是避免这些复发的一种解决办法。
