Detection of amastigotes of Trypanosoma cruzi in a kidney graft with acute dysfunction

We described a case of allograft kidney dysfunction associated with renal parenchymal infection with amastigotes of Tiypanosoma cruzi. The patient was diagnosed as being chronically infected prior to transplantation. The infection was probably acquired by blood transfusion. He could not complete antiparasitic treatment due to drug toxicity. He was transplanted from a cadaver who showed a negative test for Chagas' disease. One year after transplantation the serum creatinine progressively increased. Histological examination of renal biopsy revealed intracytoplasmic amastigotes of T cruzi. No evidence of other specific alterations in the graft was detected. It was unknown whether graft dysfunction was only due to parasitic infection. The present case confirmed that T cruzi can infect kidney grafts and that immunosuppression in kidney transplantation is potentially a cause of dissemination of Chagas' disease.