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Skin lesions, malaise, and heart failure in a renal transplant recipient
Author(s) -
Kocher C.,
Segerer S.,
Schleich A.,
Caduff R.,
Wyler L.G.,
Müller V.,
Beck B.,
Blum J.,
Kamarachev J.,
Mueller N.J.
Publication year - 2012
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/j.1399-3062.2012.00731.x
Subject(s) - medicine , malaise , transplantation , parasitemia , serology , surgery , dermatology , pathology , malaria , immunology , plasmodium falciparum , antibody
A male Caucasian patient developed nodular erythematous skin lesions, malaise, and clinical signs of progressive heart failure 4 months after renal transplantation. Bronchoscopy with bronchoalveolar lavage performed for a small infiltrate seen on a computed tomography scan revealed T rypanosoma , which had at this point not been suspected as a cause. Parasitemia was present, and reactivation rather than transmission of Chagas' disease was established by performing polymerase chain reaction and serology in the donor and recipient. Treatment with benznidazole and allopurinol successfully reduced parasitemia, but the clinical course was fatal owing to progression of severe myocarditis. The patient had never lived in an endemic area, but had an extensive travel history in S outh A merica. The last visit was more than 5 years before transplantation. In non‐endemic countries ( U nited S tates, E urope), reactivation after transplantation has only been very rarely reported. Given the rising numbers of transplantations in patients with a migration background and extensive travel histories, specific screening procedures have to be considered.