A 53-year-old man had received a cadaver-donor renal transplant from a donor with positive serology for Chagas disease. The patient had received high-dose immunosuppressive therapy due to two episodes of early acute renal allograft rejection. Three months after transplantation, he presented with unexplained fever. Multiple Trypanosoma cruzi parasites were found in a peripheral blood smear (photo and video), and a parasite load (by real-time PCR) above one million parasites per milliliter of blood was detected. Both benznidazole and itraconazole were prescribed for one year. The patient showed good clinical response after treatment and parasites disappeared from blood.
Chagas disease is an endemic zoonosis in South America, which is caused by the parasite Trypanosoma cruzi and generally transmitted by stings and contaminated defecation of triatomine bugs. Transmission through transplanted solid organs from infected donors constitutes another well-recognized mechanism of transmission.
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Footnotes
Supplementary data associated with this article can be found, in the online version, at http://dx.doi.org/10.1016/j.idcr.2017.09.001.
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