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Bronchoalveolar Lavage (BAL) for Research; Obtaining Adequate Sample Yield
Published on: March 25, 2014
Leishmaniasis diagnosed from bronchoalveolar lavage
1Department of Serology and Bacteriology, University of Helsinki, Finland.
Scandinavian Journal of Infectious Diseases
|January 1, 1992
Summary
A renal transplant patient with a history of splenectomy developed leishmaniasis, a parasitic infection, presenting as interstitial pneumonitis. Prompt diagnosis and treatment led to a full recovery, highlighting the importance of broad diagnostic methods.
Area of Science:
- Infectious Diseases
- Transplant Surgery
- Parasitology
Background:
- Renal transplant recipients with prior splenectomy are at increased risk for opportunistic infections.
- Leishmaniasis is a parasitic disease typically transmitted by sandflies, endemic in Mediterranean regions.
Observation:
- A 51-year-old patient, post-splenectomy and on immunosuppression, presented with fever and cough, initially suspected as pneumocystosis.
- Diagnosis of visceral leishmaniasis caused by Leishmania infantum was unexpectedly confirmed via bronchoalveolar lavage.
- The patient had recent travel history to Malaga, Spain, a known endemic area.
Findings:
- Isoenzyme typing confirmed the causative agent as Leishmania infantum.
- The patient's splenectomy and immunosuppressive therapy masked typical leishmaniasis symptoms, mimicking other pulmonary conditions.
- Treatment with specific antiparasitic medication resulted in rapid clinical improvement and sustained recovery over 1.5 years.
Implications:
- This case underscores leishmaniasis as a potential cause of interstitial pneumonitis in immunocompromised patients.
- It highlights the diagnostic challenge posed by atypical presentations in asplenic and immunosuppressed individuals.
- Emphasizes the utility of broad-spectrum diagnostic techniques for identifying diverse parasitic infections in clinical practice.
