Concomitant BK virus infection and visceral Leishmaniasis in a pediatric liver transplant recipient

Pediatr Transplant. 2021 Dec;25(8):e14100. doi: 10.1111/petr.14100. Epub 2021 Jul 24.

Abstract

Background: Solid organ transplant recipients are vulnerable to various unusual infections. Visceral Leishmaniasis (VL) is a protozoal opportunistic infection, which may affect the immune-suppressed hosts and solid organ transplant recipients. The BK virus infection is an evolving challenge in kidney transplant recipients. However, there are very few reports of BK virus (BKV) nephropathy involving the native kidney in liver transplant recipients. To the best of our knowledge, this is the first report of the simultaneous occurrence of these rare infections in a liver transplant recipient.

Case report: The patient was a 9-year-old girl, a case of liver transplantation who presented with the incidental finding of proteinuria, azotemia, and cytopenia. Investigations revealed that she had concomitant BKV nephropathy and visceral leishmaniasis. Both infections were successfully treated.

Conclusion: BK virus should be considered as a cause of nephropathy in liver transplant recipients. The presenting features of fever, cytopenia, and splenomegaly in a post-transplant patient should remind of unusual infections such as VL other than the common post-transplant conditions.

Keywords: BK virus; leishmaniasis; liver transplant.

Publication types

  • Case Reports

MeSH terms

  • Amphotericin B / administration & dosage
  • Antihypertensive Agents / administration & dosage
  • Antiprotozoal Agents / administration & dosage
  • BK Virus
  • Child
  • Drug Therapy, Combination
  • Female
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Incidental Findings
  • Leishmaniasis, Visceral / complications*
  • Leishmaniasis, Visceral / drug therapy*
  • Liver Transplantation*
  • Opportunistic Infections / drug therapy
  • Opportunistic Infections / virology
  • Polyomavirus Infections / drug therapy*
  • Polyomavirus Infections / virology*
  • Tumor Virus Infections / drug therapy*
  • Tumor Virus Infections / virology*
  • Viral Load

Substances

  • Antihypertensive Agents
  • Antiprotozoal Agents
  • Immunosuppressive Agents
  • Amphotericin B