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<br><br><br><div class="ecxgmail_quote"><br>From: <b class="ecxgmail_sendername">ProMED-mail</b> <span dir="ltr"><<a href="mailto:promed@promed.isid.harvard.edu">promed@promed.isid.harvard.edu</a>></span><br>
Date: 2011/3/23<br>Subject: PRO/EDR> : Leishmaniasis, visceral - Colombia: blood transfusion<br>To: <a href="mailto:promed-edr@promedmail.org">promed-edr@promedmail.org</a><br><br><br>LEISHMANIASIS - COLOMBIA: BLOOD TRANSFUSION<br>
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A ProMED-mail post<br>
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<br>
Date: Thu 10 Mar 2011<br>
Source: Transfusion [edited]<br>
<<a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1537-2995.2011.03092.x/abstract" target="_blank">http://onlinelibrary.wiley.com/doi/10.1111/j.1537-2995.2011.03092.x/abstract</a>><br>
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<br>
<br>
[Mestra L, Lopez L, Robledo SM, et al: Transfusion-transmitted<br>
visceral leishmaniasis caused by _Leishmania (Leishmania) mexicana_ in<br>
an immunocompromised patient: a case report; Transfusion (Mar 10;<br>
2011. doi: 10.1111/j.1537-2995.2011.03092.x.) [Epub ahead of print]<br>
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Background<br>
----------<br>
Transfusion-transmitted leishmaniasis is an increasing problem in<br>
areas where visceral and cutaneous leishmaniases are endemic.<br>
<br>
Case report<br>
-----------<br>
This article reports a case of transfusion-transmitted fatal visceral<br>
leishmaniasis (VL) caused by _Leishmania (Leishmania) mexicana_ in a<br>
42-year-old male resident of northwestern Colombia who after<br>
developing a terminal renal failure due to lupus nephritis received a<br>
renal transplant and multiple [blood] transfusions.<br>
<br>
Results<br>
-------<br>
Multiple intracellular _Leishmania_ amastigotes were demonstrated in<br>
both renal biopsy and marrow aspirates. Cultures of the parasite were<br>
obtained in NNN medium and the identification of the species was done<br>
both by direct immunofluorescence and polymerase chain<br>
reaction-restriction fragment length polymorphism.<br>
<br>
Conclusions<br>
-----------<br>
This is the 1st report of a VL case produced by _L. (L.) mexicana_ in<br>
Colombia, which usually is a dermotropic species. Our report suggests<br>
that although leishmaniasis is transmitted by the bite of phlebotomine<br>
sandflies, _Leishmania_ parasite may be transmitted by blood<br>
transfusion, complicating the clinical course of organ transplant and<br>
being fatal.<br>
<br>
--<br>
Communicated by:<br>
ProMED-mail<br>
<<a href="mailto:promed@promedmail.org">promed@promedmail.org</a>><br>
<br>
[The potential risk of transmitting visceral leishmaniasis, VL, by<br>
blood transfusion is rarely reported.<br>
<br>
A case from Greece, where a patient died from VL after receiving 2<br>
blood transfusions one of which had high titers against leishmania has<br>
been reported (Mpaka MA et al: Septic shock due to visceral<br>
leishmaniasis, probably transmitted from blood transfusion. J Infect<br>
Dev Ctries. 2009; 3(6): 479-83, available at<br>
<<a href="http://www.jidc.org/index.php/journal/article/view/19762964/252" target="_blank">http://www.jidc.org/index.php/journal/article/view/19762964/252</a>>). VL<br>
is endemic in southern Europe and north Africa and a serosurvey from<br>
Sicily found that 0.75 percent of blood donors were antibody positive<br>
and 0.25 percent were PCR positive (Scarlata F et al. Asymptomatic<br>
_Leishmania infantum/chagasi_ infection in blood donors of western<br>
Sicily. Trans R Soc Trop Med Hyg. 2008;102(4): 394-6; abstract<br>
available at<br>
<<a href="http://www.tropicalmedandhygienejrnl.net/article/S0035-9203%2808%2900013-8/abstract" target="_blank">http://www.tropicalmedandhygienejrnl.net/article/S0035-9203(08)00013-8/abstract</a>>).<br>
<br>
The fact that transfusion related VL is rarely reported probably<br>
means that recipients of infected blood products usually are not<br>
infected. The situation may be different in immunosuppressed patients<br>
as illustrated in the case reported in Transfusion. - Mod.EP]<br>
<br>
[The HealthMap/ProMED-mail interactive map of Colombia can be seen at<br>
<<a href="http://healthmap.org/r/00*s" target="_blank">http://healthmap.org/r/00*s</a>>. - Sr.Tech.Ed.MJ]<br>
<br>
.................................................ep/mj/lm<br>
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