Atypical presentation of cutaneous leishmaniasis in a renal transplant recipient successfully treated with allopurinol and fluconazole

• Main Authors: Soumaya Yaich, Khaled Charfeddine, Abderrahmen Masmoudi, Mondher Masmoudi, Sawssen Zaghdhane, Hamida Turki, Jamil Hachicha
• Format: Article
• Language: English
• Published: King Faisal Specialist Hospital and Research Centre 2013-03-01
• Series: Annals of Saudi Medicine
• Online Access: https://www.annsaudimed.net/doi/full/10.5144/0256-4947.2012.01.7.1510

Leishmaniasis is a zoonotic infection acquired through the bite of a female sandfly, which introduces the amastigotes of Leishmania into the bloodstream. Cutaneous leishmaniasis is rare after solid organ transplantation. Its diagnosis is difficult in immunosuppressed patients. We report a case of isolated cutaneous leishmaniasis in a renal transplant patient resident in an endemic area. The patient was successfully treated with allopurinol and fluconazole and has remained relapse-free for 44 months. The diagnosis of cutaneous leishmaniasis must be considered in immunosuppressed patients living in endemic areas. Our report shows that cutaneous leishmaniasis may complicate the clinical course of kidney transplant recipients and its presentation can be atypical. Conventional treatment with pentavalent antimonial agents can cause many side effects; of particular concern in renal transplant patients are pancreatitis and nephrotoxicity. These latter may be avoided by using a combination of allopurinol and fluconazole.