Berenguer J, Gómez-Campderá F, Padilla B, Rodríguez-Ferrero M, Anaya F, Moreno S, Valderrábano F
Servicio de Microbiología Clínica y Unidad de Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Transplantation. 1998 May 27;65(10):1401-4. doi: 10.1097/00007890-199805270-00022.
In endemic areas, visceral leishmaniasis has been identified as an opportunistic infection in patients with derangements in their cellular immune system.
We report a renal transplant patient with visceral leishmaniasis. We also reviewed the previously published cases of 17 organ transplant recipients with this parasitic disease.
Visceral leishmaniasis occurred a median time of 8 months after transplantation, and the clinical picture was characterized by fever, 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 16 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.
In endemic areas, visceral leishmaniasis may complicate the clinical course of organ transplantation and can have fatal consequences, particularly when untreated.
在流行地区，内脏利什曼病已被确认为细胞免疫系统紊乱患者的机会性感染。
我们报告了一例肾移植患者发生内脏利什曼病的病例。我们还回顾了之前发表的17例器官移植受者患这种寄生虫病的病例。
内脏利什曼病发生于移植后中位时间8个月，临床表现为发热、脾肿大和血细胞减少。18例患者中有16例在骨髓中检测到利什曼原虫，10例接受检测的患者中有8例诊断性血清学结果呈阳性。16例患者使用五价锑剂治疗，其中5例发生胰腺炎。18例患者中有5例死亡，包括2例未接受治疗的患者。13名幸存者中有4例发生内脏利什曼病复发。
在流行地区，内脏利什曼病可能使器官移植的临床过程复杂化，并可能产生致命后果，尤其是在未治疗的情况下。
