Visceral leishmaniasis: a new opportunistic infection in hematopoietic stem-cell-transplanted patients

Bueltzingsloewen, A Sirvent-von; Marty, Pierre; Rosenthal, Éric; Delaunay, Pascal; Allieri-Rosenthal, A; Gratecos, N; Cassuto, Jill‐Patrice

doi:10.1038/sj.bmt.1704396

Cited by 40 publications

(29 citation statements)

References 10 publications

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“…At (343), and 1 in a combined kidney-pancreas recipient (367) have been documented. According to several authors, the number of cases may well be underestimated.…”

Section: Infections Caused By Leishmania Sppmentioning

confidence: 99%

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

et al. 2008

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SUMMARY In recent years, the increasing number of donors from different regions of the world is providing a new challenge for the management and selection of suitable donors. This is a worldwide problem in most countries with transplantation programs, especially due to the increase in immigration and international travel. This paper elaborates recommendations regarding the selection criteria for donors from foreign countries who could potentially transmit tropical or geographically restricted infections to solid-organ transplant recipients. For this purpose, an extensive review of the medical literature focusing on viral, fungal, and parasitic infections that could be transmitted during transplantation from donors who have lived or traveled in countries where these infections are endemic has been performed, with special emphasis on tropical and imported infections. The review also includes cases described in the literature as well as risks of transmission during transplantation, microbiological tests available, and recommendations for each infection. A table listing different infectious agents with their geographic distributions and specific recommendations is included.

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“…At (343), and 1 in a combined kidney-pancreas recipient (367) have been documented. According to several authors, the number of cases may well be underestimated.…”

Section: Infections Caused By Leishmania Sppmentioning

confidence: 99%

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

et al. 2008

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“…Transplant recipients with VL develop the classic clinical form of the disease, which is a febrile hepatosplenic and pancytopenic syndrome with the parasite detectable in BMA (Sirvent-von Bueltzingsloewen et al 2004;Basset et al 2005;Veroux et al 2010). Serology has proved diagnostic applicability and can be used as a firstline diagnostic method in transplant recipients whenever VL is suspected (Basset et al 2005).…”

Section: Transfusion-transmitted Leishmaniasismentioning

confidence: 99%

Diagnosis of visceral leishmaniasis: developments over the last decade

et al. 2011

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Diagnostic parameters for visceral leishmaniasis (VL), a potentially fatal parasitic disease caused by Leishmania donovani, have been redefined in the last decade with the development of serological and molecular tests, though a definitive diagnosis still banks on the century-old parasitological methods in many areas. Recombinant antigens have improved performance of serodiagnostic methods. Serology-based tests, rk39 antigen dipstick, and direct agglutination test commonly employed in the field are highly sensitive methods, however, fail to distinguish past infections. Molecular approaches have become increasingly relevant due to remarkable sensitivity, specificity, and flexibility in choice of samples. Quantitative polymerase chain reaction is a highly sensitive and specific tool used in referral labs for detection/assessment of parasite load in VL patients and subsequently in monitoring treatment response to antileishmanial agents. The method displays potential to provide threshold for distinguishing asymptomatics in endemic areas. Currently, improvement in VL diagnostics is required for successful decentralized (point-of-care) testing in field conditions and to detect VL-HIV co-infection. Techniques such as loop-mediated isothermal amplification offer a reliable molecular diagnostic method for field application. The diagnosis based on bioanalytics/biosensors promise frontiers for point-of-care VL detection after adequate standardization. This review summarizes the recent developments in VL diagnostics, drawing attention towards the need for standardization of the diagnostics across the affected regions.

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“…HAART decreases the incidence of visceral infection [98,99]. Leishmaniasis, including visceral disease, has also been reported in patients with immunosuppression following transplantation, in people receiving chronic corticosteroid treatment, and in people with blood dyscrasias [100][101][102][103][104][105][106].…”

Section: Leishmaniasismentioning

confidence: 99%

Parasitic Central Nervous System Infections in Immunocompromised Hosts: Malaria, Microsporidiosis, Leishmaniasis, and African Trypanosomiasis

Snydman¹,

Walker²,

Kublin³

et al. 2006

Clinical Infectious Diseases

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Immunosuppression associated with HIV infection or following transplantation increases susceptibility to central nervous system (CNS) infections. Because of increasing international travel, parasites that were previously limited to tropical regions pose an increasing infectious threat to populations at risk for acquiring opportunistic infection, especially people with HIV infection or individuals who have received a solid organ or bone marrow transplant. Although long-term immunosuppression caused by medications such as prednisone likely also increases the risk for acquiring infection and for developing CNS manifestations, little published information is available to support this hypothesis. In an earlier article published in Clinical Infectious Diseases, we described the neurologic manifestations of some of the more common parasitic CNS infections. This review will discuss the presentation, diagnosis, and treatment of the following additional parasitic CNS infections: malaria, microsporidiosis, leishmaniasis, and African trypanosomiasis.As detailed in our previous article [1], the risk of acquiring fungal, viral, bacterial or parasitic infection is increased in patients receiving immunosuppressive therapy after transplantation and in people with advanced HIV infection. CNS infection occurs in 5%-10% of transplant recipients and up to 19% of patients with AIDS [2]. Patients with advanced HIV infection (CD4 + cell count, <200 cells/mm 3 ) and patients who require high levels of immunosuppression because of graft rejection or graft-versus-host disease are at greater risk than others of developing opportunistic CNS infections. Although parasitic CNS infection can occur in any host, some infections are more common among patients undergoing specific types of transplantation (table 1). The clinical and radiographic manifestations of parasitic CNS infection are often similar in immunocompromised and immunocompetent hosts, but certain infections may blunt or enhance these manifestations in immunosuppressed hosts [3,4]. Although neurologic symptoms vary somewhat by infecting parasite, they are mainly determined by the location(s) of the infection within the CNS (table 2).Evaluation of the immunosuppressed host presenting with neurologic symptoms or signs of infection should be guided by (1) the degree of immunosuppression, type of transplant received,

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Visceral leishmaniasis: a new opportunistic infection in hematopoietic stem-cell-transplanted patients

Cited by 40 publications

References 10 publications

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

Diagnosis of visceral leishmaniasis: developments over the last decade

Parasitic Central Nervous System Infections in Immunocompromised Hosts: Malaria, Microsporidiosis, Leishmaniasis, and African Trypanosomiasis

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