Recurrent cytomegalovirus disease, visceral leishmaniosis, and Legionella pneumonia after liver transplantation: a case report View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2004-01

AUTHORS

Nermin Halkic, Riadh Ksontini, Beatrix Scholl, Catherine Blanc, Tibor Kovacsovics, Pascal Meylan, Carmen Muheim, Michel Gillet, François Mosimann

ABSTRACT

PurposeRecurrent cytomegalovirus (CMV) disease is a frequent complication of liver transplantation. Visceral leishmaniosis in a transplant recipient is, on the other hand, extremely rare and only two cases of kala-azar have been described after liver transplantation. Immunosuppressed patients are known to be at risk of Legionella infection and the relationship between infection with this organism and hospital water supplies has been well described. These three diseases carry a high mortality rate. Our report examines the potential relationship between these complications.Clinical featuresWe describe the case of a liver transplant recipient who presented the three complications successively and survived. After reviewing the literature, we explore hypotheses linking these infections and discuss treatment strategies.ConclusionsIn the patient described, infection with leishmania probably occurred months prior to the clinical presentation, a delay that matches the incubation period of kala-azar. The simultaneous onset of leishmaniosis and of a high CMV viremia may have been a coincidence. However, CMV infection has been shown to be an independent predictor of invasive fungal infection in liver transplant recipients. CMV does indeed have a suppressive effect on the humoral and cellular immune responsein vitro as well asin vivo. The clinical manifestations of leishmaniosis may, therefore, have been precipitated in this patient by the additive immunosuppressive effect of antirejection drugs and CMV. More... »

PAGES

84

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/bf03018554

DOI

http://dx.doi.org/10.1007/bf03018554

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1023511538

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/14709468


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