Rare Infection Traced to Organ Donor After Two-Week Fever Mystery

A 14-year-old girl, identified as Shelly, who underwent a complex double transplant of a liver and pancreas, suffered from a persistent fever and elevated inflammation markers 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 administered standard antibiotic treatments, but the fever did not subside. The medical team expanded their investigation to include less common pathogens, but no definitive cause was found. Shelly, who had been living with chronic liver disease and type 1 diabetes, had received the organs from a girl who died from a domestic accident. Upon learning the donor's background, Dr. Ephraim Bilavsky, Director of the Infectious Diseases Unit, decided to administer doxycycline, an antibiotic effective against unusual bacteria. This treatment dramatically reduced Shelly's fever and inflammation within 24 hours. Although a specific pathogen could not be definitively identified, Dr. Bilavsky believes the doxycycline was crucial. The case highlighted the importance of considering the donor's medical history when diagnosing infections in organ transplant recipients, as rare infections can be transmitted through transplanted organs. Shelly has since recovered and is living a new life thanks to the successful transplant and the thorough medical investigation.