POS-730 Cutaneous leishmaniasis in a renal transplant recipient

Cutaneous leishmaniasis is a parasitic infection caused by flagellate parasite of the genus Leishmania. It most often zoonotic disease transmitted bite sandflies. We report case renal transplant recipient who presented with cutaneous leishmaniasis. A 32-year-old man from Gafsa was received kidney in September 2017 living related donor (5 HLA identities). The induction immunosuppression based on solumedrol and anti-lymphocyte serum. maintenance mycophenolate mofetil, tacrolimus prednisone. He January 2019 two nodular lesions ankles (opposite joint), were painless non-itchy ulcerative, one centimeter diameter each. skin smear showed bodies leishmanias. Initially he metronidazol 1500 mg per day for month local care, cryotherapy we reduce doses immunosuppressive drugs. After 17 days antibiotic therapy, developed bicytopenia (thrombocytopenia + leukopenia). Mycophenolate mofetil discontinued increased dose corticosteroids. myelogram done to rule out visceral or infectious macrophagic activation syndrome, marrow moderate richness an excess promyelocytes myelocytes. diagnosis toxicity, which ended improvement blood count gradual reintroduction mofetil. patient only 6 months resulted lesions. Infection reactivation after has been rarely reported.