[Leish-l] FW: PRO/EDR> : Leishmaniasis, visceral - Colombia: blood transfusion

[jeffrey shaw]

From: ProMED-mail <promed at promed.isid.harvard.edu>

Date: 2011/3/23
Subject: PRO/EDR> : Leishmaniasis, visceral - Colombia: blood transfusion
To: promed-edr at promedmail.org


LEISHMANIASIS - COLOMBIA: BLOOD TRANSFUSION


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Date: Thu 10 Mar 2011

Source: Transfusion [edited]

<http://onlinelibrary.wiley.com/doi/10.1111/j.1537-2995.2011.03092.x/abstract>

[subscription required for full article]





[Mestra L, Lopez L, Robledo SM, et al: Transfusion-transmitted

visceral leishmaniasis caused by _Leishmania (Leishmania) mexicana_ in

an immunocompromised patient: a case report; Transfusion (Mar 10;

2011. doi: 10.1111/j.1537-2995.2011.03092.x.) [Epub ahead of print]

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Background

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Transfusion-transmitted leishmaniasis is an increasing problem in

areas where visceral and cutaneous leishmaniases are endemic.



Case report

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This article reports a case of transfusion-transmitted fatal visceral

leishmaniasis (VL) caused by _Leishmania (Leishmania) mexicana_ in a

42-year-old male resident of northwestern Colombia who after

developing a terminal renal failure due to lupus nephritis received a

renal transplant and multiple [blood] transfusions.



Results

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Multiple intracellular _Leishmania_ amastigotes were demonstrated in

both renal biopsy and marrow aspirates. Cultures of the parasite were

obtained in NNN medium and the identification of the species was done

both by direct immunofluorescence and polymerase chain

reaction-restriction fragment length polymorphism.



Conclusions

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This is the 1st report of a VL case produced by _L. (L.) mexicana_ in

Colombia, which usually is a dermotropic species. Our report suggests

that although leishmaniasis is transmitted by the bite of phlebotomine

sandflies, _Leishmania_ parasite may be transmitted by blood

transfusion, complicating the clinical course of organ transplant and

being fatal.



--

Communicated by:

ProMED-mail

<promed at promedmail.org>



[The potential risk of transmitting visceral leishmaniasis, VL, by

blood transfusion is rarely reported.



A case from Greece, where a patient died from VL after receiving 2

blood transfusions one of which had high titers against leishmania has

been reported (Mpaka MA et al: Septic shock due to visceral

leishmaniasis, probably transmitted from blood transfusion. J Infect

Dev Ctries. 2009; 3(6): 479-83, available at

<http://www.jidc.org/index.php/journal/article/view/19762964/252>). VL

is endemic in southern Europe and north Africa and a serosurvey from

Sicily found that 0.75 percent of blood donors were antibody positive

and 0.25 percent were PCR positive (Scarlata F et al. Asymptomatic

_Leishmania infantum/chagasi_ infection in blood donors of western

Sicily. Trans R Soc Trop Med Hyg. 2008;102(4): 394-6; abstract

available at

<http://www.tropicalmedandhygienejrnl.net/article/S0035-9203(08)00013-8/abstract>).



The fact that transfusion related VL is rarely reported probably

means that recipients of infected blood products usually are not

infected. The situation may be different in immunosuppressed patients

as illustrated in the case reported in Transfusion. - Mod.EP]



[The HealthMap/ProMED-mail interactive map of Colombia can be seen at

<http://healthmap.org/r/00*s>. - Sr.Tech.Ed.MJ]



.................................................ep/mj/lm

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