Elderly kidney transplant recipient with intermittent fever: A case report of leishmaniasis with acute kidney injury during liposomal amphotericin B therapy

J. A. Pedroso, Maria Paola Salerno, Gionata Spagnoletti, M. Bertucci-Zoccali, G. Zaccone, V. Bianchi, Jacopo Romagnoli, Franco Citterio

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

We present a case report of visceral leishmaniasis in an elderly kidney transplant recipient (age, 73 years) with high intermittent fever in the 2 months before admission. Symptoms started 16 years after transplant. The patient received appropriate treatment with liposomal amphotericin and experienced transient increases in serum creatinine levels. Progression to dialysis was avoided with short duration of therapy (5 consecutive days, plus 1 more dose 1 week apart, a schedule alternative to 15-21 days [supported by the literature]) and a temporary reduction in tacrolimus exposure. After 4 months, recurrence of symptoms without other explanation required a second bone marrow aspirate; it revealed the persistence of amastigote forms. Visceral leishmaniasis is a potentially life-threatening infection; to the best of our knowledge, this is the oldest transplanted patient with a case of leishmaniasis described in the literature.
Original languageEnglish
Pages (from-to)2365-2367
Number of pages3
JournalTransplantation Proceedings
Volume46
DOIs
Publication statusPublished - 2014

Keywords

  • Acute Kidney Injury
  • Aged
  • Amphotericin B
  • Antiprotozoal Agents
  • Creatinine
  • Female
  • Fever
  • Humans
  • Kidney Transplantation
  • Leishmaniasis, Visceral
  • Liposomes
  • Recurrence
  • Renal Dialysis
  • Tacrolimus
  • Transplant Recipients

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