Titre
Recurrent cytomegalovirus disease, visceral leishmaniosis, and Legionella pneumonia after liver transplantation: a case report
Type
étude de cas
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Halkic, N.
Auteure/Auteur
Ksontini, R.
Auteure/Auteur
Scholl, B.
Auteure/Auteur
Blanc, C.
Auteure/Auteur
Kovacsovics, T.
Auteure/Auteur
Meylan, P.
Auteure/Auteur
Muheim, C.
Auteure/Auteur
Gillet, M.
Auteure/Auteur
Mosimann, F.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
0832-610X
Statut éditorial
Publié
Date de publication
2004
Volume
51
Numéro
1
Première page
84
Dernière page/numéro d’article
87
Peer-reviewed
Oui
Langue
anglais
Notes
DA - 20040107
LA - eng
PT - Case Reports
PT - Journal Article
RN - 0 (Anti-Bacterial Agents)
RN - 0 (Antimony Sodium Gluconate)
RN - 0 (Antiviral Agents)
RN - 0 (Schistosomicides)
RN - 4428-95-9 (Foscarnet)
RN - 81103-11-9 (Clarithromycin)
RN - 82410-32-0 (Ganciclovir)
SB - IM
LA - eng
PT - Case Reports
PT - Journal Article
RN - 0 (Anti-Bacterial Agents)
RN - 0 (Antimony Sodium Gluconate)
RN - 0 (Antiviral Agents)
RN - 0 (Schistosomicides)
RN - 4428-95-9 (Foscarnet)
RN - 81103-11-9 (Clarithromycin)
RN - 82410-32-0 (Ganciclovir)
SB - IM
Résumé
PURPOSE: Recurrent 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 FEATURES: We 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. CONCLUSIONS: In 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 response in vitro as well as in vivo. The clinical manifestations of leishmaniosis may, therefore, have been precipitated in this patient by the additive immunosuppressive effect of antirejection drugs and CMV
Sujets
PID Serval
serval:BIB_56E8043034A1
PMID
Open Access
Oui
Date de création
2008-02-18T12:30:47.406Z
Date de création dans IRIS
2025-05-20T13:38:26Z
Fichier(s)![Vignette d'image]()
En cours de chargement...
Nom
out.pdf
Version du manuscrit
published
Taille
156.2 KB
Format
Adobe PDF
PID Serval
serval:BIB_56E8043034A1.P001
URN
urn:nbn:ch:serval-BIB_56E8043034A19
Somme de contrôle
(MD5):5f9b852404ac5a29f2e77478da2335a3