Unexpected Guest in a Kidney Transplant: Dangerous Tick Bacteria
In an unusual turn of events, a donated kidney led to an unconventional spread of an elusive germ. Scientists recently documented this occurrence in a published paper, revealing that a person's infected donated kidney was the source of transmission for a tick-borne ailment, known as ehrlichiosis.
This transplant tale kicked off when both the living donor and the recipient experienced health setbacks soon after their operations. Upon investigation, the donor was found to have transmitted an infection caused by the Ehrlichia bacteria, a notorious germ carrier often associated with ticks. Lucky for them, the infection was caught early, enabling both patients to recover successfully.
Tick-borne illnesses, like Lyme disease, relapsing fever, and ehrlichiosis, are prevalent carriers. Ehrlichiosis is primarily caused by the Ehrlichia chaffeensis bacteria, with a small fraction of cases associated with other bacterial species. Although the disease is rare, reported cases have been on the rise over the years, surging from 2000's 201 cases to 1,570 in 2022. However, this recent case was even rarer than the ordinary.
The 33-year-old Minnesota donor, who underwent routine screenings before the surgery, exhibited no concerning red flags. On the other hand, the recipient, a 24-year-old man from Wisconsin with end-stage kidney disease, showed no typical ehrlichiosis risk factors, except for his recent organ transplant.
Following uneventful operations, the donor developed a rash and muscle pain the day after the transplant. He was diagnosed with rhabdomyolysis, requiring a swift recovery strategy. Meanwhile, the recipient displayed symptoms a week afterward, including fever, joint pain, and fluid build-up in the kidneys. A tickborne illness test confirmed the presence of E. chaffeensis bacteria, leading to a course of antibiotics. Both patients eventually made a full recovery.
State health agencies require the reporting of all ehrlichiosis cases in the U.S. Given the recipients' unique circumstances, health officials in both Minnesota and Wisconsin were alerted to investigate further. Discovery of the donor's travel history and his recent tick encounters during a hunting trip in Kansas ultimately linked the transmission to the tainted organ donation.
Using this unique case as a foundation, doctors emphasize the importance of vigilance in tracking potential tickborne infections in organ donors and recipients. Although routine screening for ehrlichiosis is not standard practice due to its rarity, transplant doctors should maintain an observant attitude to ensure they mitigate all possible risks associated with germs commonly spread by ticks.
This uncommon case of ehrlichiosis transmission highlights the potential future implications of enhanced screening procedures for tick-borne diseases in organ donors. The surge in ehrlichiosis cases, reaching 1,570 in 2022, underscores the need for further scientific research in this field. The confirmation of E. chaffeensis bacteria in the recipient's body, despite his lack of typical risk factors, demonstrates the infectious nature of this tick-borne ailment. And looking ahead to 2022, healthcare professionals should remain vigilant against the potential threats posed by infectious organ donations, given the rising incidence of ehrlichiosis.
