Japanese spotted fever and irreversible renal dysfunction during immunosuppressive therapy after a living-donor kidney transplant

Ten years ago, a 56-year-old woman with a history of IgA nephropathy who received a living-donor kidney transplant across ABO barriers was managed with immunosuppressive drugs. The kidney transplant donor was her father who had poor kidney function. The patient's renal function was stable for 1...

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Bibliographic Details
Published in:Tropical medicine and infectious disease 2022-08, Vol.7 (8), p.1-5
Main Authors: Kondo, Makoto, Nishikawa, Kohei, Iida, Shohei, Nakanishi, Takehisa, Habe, Koji, Yamanaka, Keiichi
Format: Article
Language:English
Subjects:
Abdomen
Arachnids
atypical skin rash
Bacterial infections
Blood
Care
Case Report
Cytokines
Cytomegalovirus
Diabetes
Diseases
Drugs
Erythema
Fever
Hypertension
Immunosuppressive agents
immunosuppressive drugs
Infections
Japanese spotted fever
Kidney transplants
Kidneys
Laboratories
living-donor kidney transplant
Patients
Proteins
Skin
Transplantation
Typhus
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Summary:Ten years ago, a 56-year-old woman with a history of IgA nephropathy who received a living-donor kidney transplant across ABO barriers was managed with immunosuppressive drugs. The kidney transplant donor was her father who had poor kidney function. The patient's renal function was stable for 10 years. The patient visited our department with a complaint of skin rash, occurring 2 days after an onset of fever. Although a skin rash is atypical for Japanese spotted fever (JSF), we suspected JSF and started treatment with minocycline because we found a scar suggestive of an eschar. Furthermore, the blood test results were similar to those associated with JSF, and the patient lived in a JSF-endemic area. The patient's symptoms improved after 1 week. She was diagnosed with JSF by serological tests against 'Rickettsia japonica'. JSF usually does not cause any complications after recovery. However, the patient's renal function did not completely recover. JSF can cause an atypical rash in patients taking excessive immunosuppressive drugs. Early treatment is required for patients with suspected JSF to prevent complications of renal dysfunction after receiving a living-donor kidney transplant.
ISSN:2414-6366
2414-6366
DOI:10.3390/tropicalmed7080175