Rare Donor Factor Solves Two-Week Fever Mystery in Transplant Patient

A 14-year-old girl, identified as Shelly, who underwent a complex double transplant of a liver and pancreas, suffered from a persistent fever for two weeks post-surgery. Doctors at Schneider Children's Medical Center, the only facility in Israel performing pediatric liver transplants, initially suspected a common infection and conducted extensive tests, but the cause remained elusive. The girl had been suffering from chronic liver disease and type 1 diabetes, leading to the combined transplant aimed at freeing her from insulin injections.

Despite the high fever and inflammation markers, the transplanted organs functioned well, and Shelly felt generally good between fever episodes. When standard treatments and broad-spectrum antibiotics failed, the medical team began to explore less common possibilities. A crucial turning point came when the liver transplant coordinator, Michal Shapir, discovered the liver had been donated by a girl from the Bedouin community who had died in a tragic home accident.

This new information prompted Professor Ephraim Bilavsky, Director of the Infectious Diseases Unit, to change the treatment approach. He prescribed doxycycline, an antibiotic not typically used in such cases but effective against certain unusual bacteria. Within 24 hours, the girl's fever subsided, and inflammation markers began to decrease.

While a definitive bacterial cause could not be isolated, Professor Bilavsky is convinced that the doxycycline treatment was the key to her recovery. He emphasized that this case highlighted the critical importance of considering the donor's background when diagnosing infections in organ transplant recipients, as rare infections can sometimes be transmitted via the donated organ. Shelly received a new lease on life thanks to the successful transplant and a medical approach that accounted for even the most obscure details.