Postrenal transplant Plasmodium vivax malaria: neglected and not benign
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Postrenal transplant Plasmodium vivax malaria: neglected and not benign Vivek B. Kute & Aruna V. Vanikar & Pankaj R. Shah & Jigar D. Shrimali & Manoj R. Gumber & Himanshu V. Patel & Pranjal R. Modi & Hargovind L. Trivedi
Received: 14 September 2012 / Accepted: 28 November 2012 / Published online: 13 December 2012 # Springer-Verlag Berlin Heidelberg 2012
Abstract Plasmodium vivax is causing increasingly more cases of severe malaria worldwide. We reported a case of postrenal transplantation acute kidney injury (AKI) associated with P. vivax, a neglected human malaria parasite. The diagnosis of P. vivax monoinfection was confirmed by direct visualization of the parasite in blood smear and rapid diagnostic test. On admission, serum creatinine (SCr.) increased from 1.45 to 3.7 mg/ V. B. Kute (*) : P. R. Shah : J. D. Shrimali : M. R. Gumber : H. V. Patel : H. L. Trivedi Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases & Research Centre (IKDRC), Dr. H.L. Trivedi Institute of Transplantation Sciences (ITS), Civil Hospital Campus, Asarwa, Ahmedabad 380016 Gujarat, India e-mail: [email protected] P. R. Shah e-mail: [email protected] J. D. Shrimali e-mail: [email protected] M. R. Gumber e-mail: [email protected] H. V. Patel e-mail: [email protected] H. L. Trivedi e-mail: [email protected] A. V. Vanikar Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, IKDRC-ITS, Ahmedabad, India e-mail: [email protected] P. R. Modi Department of Urology and Transplantation, IKDRC-ITS, Ahmedabad, India e-mail: [email protected]
dl. The other etiologies of fever and AKI were ruled out. He responded to prompt therapy with antimalarial drugs. There was no change in tacrolimus trough level before and after antimalarial drugs. Two weeks after discharge, his SCr. was 1.43 mg/dl. Our patient lived in an endemic malarial area and the transplant took place in December 2010. The patient subsequently presented with clinical malaria in June 2012, so we thought that posttransplantation transmission by the mosquito was a possibility and very less likely that other dormant form of the parasite had been the source of the clinical infection. P. vivax can lead to as AKI in renal transplant recipient. P. vivax should be considered in the differential diagnosis of fever in transplant recipients who had received organs or blood products from malaria-endemic area to facilitate a prompt diagnosis and adequate treatment.
Malaria remains a serious health problem in many parts of the world (Jensen and Mehlhorn 2009; Elsheikha and Sheashaa 2007; Kochar et al. 2009). Epidemiologic studies and clinical description of severe Plasmodium vivax malaria in renal transplant recipients living in malaria-endemic areas are rare and more attention is needed to understand the rising severity of the disease and the increasing incidences of resistance shown by this parasite towards usual therapeutic regimens in renal transplant recipi
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