Although cases of leishmaniasis co-infection have been described
in acquired immunodeficiency syndrome patients as well as those who have
undergone organ transplants, to our knowledge, the present report is the
first documented case of simultaneous cutaneous, visceral and ocular leishmaniasis
due to
Leishmania (Viannia)
braziliensis
in a transplant patient. The patient had been using immunosuppressive drugs
since receiving a transplanted kidney. The first clinical signs of leishmaniasis
included fever, thoracic pain, hepatosplenomegaly, leucopenia and anemia.
The cutaneous disease was revealed by the presence of amastigotes in the
skin biopsy. After three months, the patient presented fever with conjunctive
hyperemia, intense ocular pain and low visual acuity. Parasites isolated
from iliac crest, aqueous humor and vitreous body were examined using a
range of molecular techniques. The same strain of
L. (V.) braziliensis
was responsible for the different clinical manifestations. The immunosuppressive
drugs probably contributed to the dissemination of
Leishmania
.
