Visceral leishmaniasis in heart transplant patients in the endemic state of Ceará, Brazil: a report of two cases

Visceral leishmaniasis (VL) in transplant patients is a serious disease, with atypical and aggressive manifestations, compromising patient survival. During the period from 2008 to 2012, 126 heart transplants were performed in the state of Ceará, Brazil, of which, two patients developed VL. Fever, pancytopenia and hepatosplenomegaly were the common clinical signs. Both patients were diagnosed and properly treated, but the first one had a clinical relapse and died, five months after treatment. These findings emphasize the importance of investigating VL in heart-transplant patients in endemic areas and highlight the importance of early diagnosis and treatment for favorable clinical outcomes.