Early post-transplant cutaneous bacillary angiomatosis in a kidney recipient: Case report and review of the literature.

Autor: Morillas JA; Department of Infectious Diseases, Cleveland Clinic, Cleveland, OH, USA.; Transplantation Center, Cleveland Clinic, Cleveland, OH, USA., Hassanein M; Department of Nephrology, Cleveland Clinic, Cleveland, OH, USA., Syed B; Department of Nephrology, University of Mississippi Medical Center, Jackson, MS, USA., Liaqat A; Department of Nephrology, Cleveland Clinic, Cleveland, OH, USA., Bergfeld W; Department of Dermatology and Pathology, Cleveland Clinic, Cleveland, OH, USA., Sardiña LA; Department of Dermatology and Pathology, Cleveland Clinic, Cleveland, OH, USA., Fatica R; Department of Nephrology, Cleveland Clinic, Cleveland, OH, USA.; Transplantation Center, Cleveland Clinic, Cleveland, OH, USA., Lum J; Department of Infectious Diseases, Cleveland Clinic, Cleveland, OH, USA.; Transplantation Center, Cleveland Clinic, Cleveland, OH, USA.
Jazyk: angličtina
Zdroj: Transplant infectious disease : an official journal of the Transplantation Society [Transpl Infect Dis] 2021 Aug; Vol. 23 (4), pp. e13670. Date of Electronic Publication: 2021 Jul 08.
DOI: 10.1111/tid.13670
Abstrakt: Bacillary angiomatosis (BA) is an uncommon systemic disease caused by Bartonella henselae (BH) or Bartonella quintana (BQ) that occurs primarily in immunocompromised hosts. Few cases of BA recipients have been reported in adult solid transplant recipients over the years, with most cases presenting years after transplant. We describe a case of a kidney transplant recipient who developed cutaneous BA very early in the post-transplant period despite not having any exposures. Retrospective testing of donor and recipient's serum was performed and raised the concern for possible donor-derived infection. A literature review encompassing 1990 to present was also performed in order to better understand the clinical presentation, diagnostics and therapeutic approach of this unusual disease. Combined serology, histopathology and molecular testing (polymerase chain reaction [PCR]) were useful in diagnosing BA in our patient as serology alone might be unreliable. Macrolides or doxycycline for at least 3 months is the recommended therapeutic strategy; however, the optimal duration of treatment is not well established in transplant recipients. In our patient, we decided to use doxycycline for 1 year due to gradual resolution of lesions and ongoing immunosuppression. Patient responded successfully without any documented relapse.
(© 2021 Wiley Periodicals LLC.)
Databáze: MEDLINE
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