Trypanosoma cruzi

Record number: 
Adverse Occurrence type: 
MPHO Type: 
Time to detection: 
36 - 116 days
Alerting signals, symptoms, evidence of occurrence: 
Four patients received kidney transplants from related (one patient) and unrelated donors (three patients). All donors were positive for Trypanosoma cruzi antibodies by complement fixation tests. All four kidney transplant patients developed fever and Trypanosoma cruzi parasitemia shown in buffy coat concentrates of peripheral blood. After fevers developed, each patient was tested and found negative for Trypanosoma cruzi antibodies by tests using indirect immunofluorescence, complement fixation and passive immunohemagglutination (thus implying and acute new infection rather that reactivation). One male received a kidney from his mother and a second kidney from his sister 9 months later. He died 10 months after his second transplant. He developed fever due to Trypanosoma cruzi 90 days post-op. Two other recipients developed fevers thought due to Trypanosoma cruzi 36 and 117 days post-op. Data from one of the patients doesn't give a latency period.
Demonstration of imputability or root cause: 
Likely. Donors, carriers and recipients developed acute infection, likely was acquired from the kidney (tested negative when infection first develpoed) not reactivation but not proven. In two cases transfusion may have contributed but this is unlikely because of the long interval between transfusion and acute infection.
Imputability grade: 
1 Possible
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