American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2026
Spiroplasma infection complicated by macrophage activation syndrome and fulminant hepatitis in a kidney transplant recipient.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Farhat Imane, Kaminski Hannah, Woerther Paul Louis, Rodriguez Christophe, Pierre Cappy, Cheval Justine, Korbi Skander, Couzi Lionel, Merville Pierre, Jambon Frédéric, Moreau Karine
Аннотация
A 65-year-old kidney transplant recipient was admitted with isolated fever. Initial tests revealed pancytopenia and elevated C-reactive protein levels but failed to detect any pathogen. A bone marrow aspirate was performed because of signs suggestive of hemophagocytic lymphohistiocytosis, but the results were negative. The patient subsequently developed fulminant hepatitis. Liver biopsy showed severe acute cytolytic hepatitis with a neutrophil-rich infiltrate, suppurative hepatocytic necrosis, and hemophagocytosis. Etoposide, N-acetylcysteine, and piperacillin-tazobactam were initiated. However, the patient died from hemorrhagic complications of the biopsy. Posthumous shotgun metagenomics on liver samples identified Spiroplasma ixodetis.