Visceral dissemination of mucocutaneous leishmaniasis in a kidney transplant recipient

Detalhes bibliográficos
Autor(a) principal: Marques, N
Data de Publicação: 2021
Outros Autores: Bustorff, M, Cordeiro-da-Silva, A, Pinto, AI, Santarém, N, Ferreira, F, Nunes, A, Cerqueira, A, Rocha, A, Ferreira, I, Tavares, I, Santos, J, Fonseca, E, Moura, C, Cerejeira, A, Vide, J, Cancela, J, Simões, JS, Sampaio, S
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://hdl.handle.net/10216/150430
Resumo: Intracellular protozoan of the genus Leishmania, endemic in the Mediterranean basin, are the cause of cutaneous (CL), mucocutaneous (MCL), and visceral leishmaniasis (VL). A 75-year-old woman was admitted nine years after a second kidney transplant (KT), due to persistent pancytopenia and fever. She presented edema and erythema of the nose in the last two years and an exophytic nodular lesion located on the left arm, with areas of peripheral necrosis and central ulceration in the last 18 months. A bone marrow biopsy revealed features compatible with Leishmania amastigotes, and polymerase chain reaction test (PCR) for Leishmania infantum was positive. Moreover, biopsy and PCR for L. infantum of the cutaneous lesion on the patient’s left arm and nose and PCR from peripheral blood were positive. Thus, a diagnosis of CL, MCL, and VL was made, and liposomal amphotericin B was initiated, but the patient had an unfavorable outcome and died. This is the first report of a KT recipient presenting with the entire spectrum of leishmaniasis. In Portugal, this infection is rare—so a high degree of clinical suspicion is required for its diagnosis, especially in endemic regions, as visceral leishmaniasis is a potentially life-threatening infection.
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spelling Visceral dissemination of mucocutaneous leishmaniasis in a kidney transplant recipientIntracellular protozoan of the genus Leishmania, endemic in the Mediterranean basin, are the cause of cutaneous (CL), mucocutaneous (MCL), and visceral leishmaniasis (VL). A 75-year-old woman was admitted nine years after a second kidney transplant (KT), due to persistent pancytopenia and fever. She presented edema and erythema of the nose in the last two years and an exophytic nodular lesion located on the left arm, with areas of peripheral necrosis and central ulceration in the last 18 months. A bone marrow biopsy revealed features compatible with Leishmania amastigotes, and polymerase chain reaction test (PCR) for Leishmania infantum was positive. Moreover, biopsy and PCR for L. infantum of the cutaneous lesion on the patient’s left arm and nose and PCR from peripheral blood were positive. Thus, a diagnosis of CL, MCL, and VL was made, and liposomal amphotericin B was initiated, but the patient had an unfavorable outcome and died. This is the first report of a KT recipient presenting with the entire spectrum of leishmaniasis. In Portugal, this infection is rare—so a high degree of clinical suspicion is required for its diagnosis, especially in endemic regions, as visceral leishmaniasis is a potentially life-threatening infection.MDPI20212021-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/10216/150430eng2076-081710.3390/pathogens10010018Marques, NBustorff, MCordeiro-da-Silva, APinto, AISantarém, NFerreira, FNunes, ACerqueira, ARocha, AFerreira, ITavares, ISantos, JFonseca, EMoura, CCerejeira, AVide, JCancela, JSimões, JSSampaio, Sinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-09-27T09:05:40Zoai:repositorio-aberto.up.pt:10216/150430Portal AgregadorONGhttps://www.rcaap.pt/oai/openairemluisa.alvim@gmail.comopendoar:71602024-09-27T09:05:40Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Visceral dissemination of mucocutaneous leishmaniasis in a kidney transplant recipient
title Visceral dissemination of mucocutaneous leishmaniasis in a kidney transplant recipient
spellingShingle Visceral dissemination of mucocutaneous leishmaniasis in a kidney transplant recipient
Marques, N
title_short Visceral dissemination of mucocutaneous leishmaniasis in a kidney transplant recipient
title_full Visceral dissemination of mucocutaneous leishmaniasis in a kidney transplant recipient
title_fullStr Visceral dissemination of mucocutaneous leishmaniasis in a kidney transplant recipient
title_full_unstemmed Visceral dissemination of mucocutaneous leishmaniasis in a kidney transplant recipient
title_sort Visceral dissemination of mucocutaneous leishmaniasis in a kidney transplant recipient
author Marques, N
author_facet Marques, N
Bustorff, M
Cordeiro-da-Silva, A
Pinto, AI
Santarém, N
Ferreira, F
Nunes, A
Cerqueira, A
Rocha, A
Ferreira, I
Tavares, I
Santos, J
Fonseca, E
Moura, C
Cerejeira, A
Vide, J
Cancela, J
Simões, JS
Sampaio, S
author_role author
author2 Bustorff, M
Cordeiro-da-Silva, A
Pinto, AI
Santarém, N
Ferreira, F
Nunes, A
Cerqueira, A
Rocha, A
Ferreira, I
Tavares, I
Santos, J
Fonseca, E
Moura, C
Cerejeira, A
Vide, J
Cancela, J
Simões, JS
Sampaio, S
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Marques, N
Bustorff, M
Cordeiro-da-Silva, A
Pinto, AI
Santarém, N
Ferreira, F
Nunes, A
Cerqueira, A
Rocha, A
Ferreira, I
Tavares, I
Santos, J
Fonseca, E
Moura, C
Cerejeira, A
Vide, J
Cancela, J
Simões, JS
Sampaio, S
description Intracellular protozoan of the genus Leishmania, endemic in the Mediterranean basin, are the cause of cutaneous (CL), mucocutaneous (MCL), and visceral leishmaniasis (VL). A 75-year-old woman was admitted nine years after a second kidney transplant (KT), due to persistent pancytopenia and fever. She presented edema and erythema of the nose in the last two years and an exophytic nodular lesion located on the left arm, with areas of peripheral necrosis and central ulceration in the last 18 months. A bone marrow biopsy revealed features compatible with Leishmania amastigotes, and polymerase chain reaction test (PCR) for Leishmania infantum was positive. Moreover, biopsy and PCR for L. infantum of the cutaneous lesion on the patient’s left arm and nose and PCR from peripheral blood were positive. Thus, a diagnosis of CL, MCL, and VL was made, and liposomal amphotericin B was initiated, but the patient had an unfavorable outcome and died. This is the first report of a KT recipient presenting with the entire spectrum of leishmaniasis. In Portugal, this infection is rare—so a high degree of clinical suspicion is required for its diagnosis, especially in endemic regions, as visceral leishmaniasis is a potentially life-threatening infection.
publishDate 2021
dc.date.none.fl_str_mv 2021
2021-01-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://hdl.handle.net/10216/150430
url https://hdl.handle.net/10216/150430
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 2076-0817
10.3390/pathogens10010018
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dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
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reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv mluisa.alvim@gmail.com
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