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
Author Information
Vivek B Kute: 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. drvivekkute@rediffmail.com
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/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.
