Cutaneous leishmaniasis before and after renal transplantation; a case report

Cutaneous leishmaniasis is an endemic infectious disease in Iran caused by flagellated protozoa. The most common cause of cutaneous leishmaniasis is L. major. We report a case of disseminated cutaneous leishmaniasis after renal transplantation.Patient: A 50-year old man received renal transplantation three months ago for diabetes mellitus-associated renal failure. Before renal transplantation, he gave the history of insect bite and a single nodule that was clinically diagnosed as local cutaneous leishmaniasis, however, he had not received therapy. Three months after transplantation while he was on immunosuppressive therapy, he was admitted for disseminated cutaneous nodule. Direct smear and pathology detected lieshman body and amastigote in the lesion compatible with the diagnosis of disseminated cutaneous lishmaniasis. Despite difficult therapeutic approach, he cured after combination therapy with glucontim and amphotricin B for one month. In countries like Iran where leishmaniasis is endemic, each nodule or chronic skin lesion should be evaluated for cutaneous leishmaniasis. Transplant clinicians should have a high index of suspicion of leishmania infections as an important cause of post transplant morbidity.