# Cutaneous leishmaniasis in a renal transplant patient: Diagnostic challenges in a non-endemic setting

## TL;DR

A renal transplant patient from Nepal developed cutaneous leishmaniasis, showing the need to consider this disease in non-endemic areas for immunocompromised individuals.

## Contribution

Highlights diagnostic challenges and the importance of considering leishmaniasis in immunocompromised patients from endemic regions.

## Key findings

- A renal transplant patient presented with cutaneous leishmaniasis after initial misdiagnosis.
- Liposomal amphotericin B treatment was effective in managing the infection.
- Immunocompromised individuals from endemic regions should be evaluated for leishmaniasis.

## Abstract

Leishmanial infections, though uncommon in Southeast and Central Asia, remain clinically significant due to their potential to cause substantial morbidity and mortality. This case report presents a young Nepalese male, four years post-renal transplant and with chronic allograft dysfunction secondary to non-compliance, who presented with a right chest skin lesion and fever. Initially suspected to be cutaneous tuberculosis or malignancy, investigations, including a skin biopsy, revealed cutaneous leishmaniasis. The patient responded well to treatment with liposomal amphotericin B, highlighting the importance of considering leishmaniasis in differential diagnoses, especially in immunocompromised individuals from, or travelling to, endemic regions.