Digestive leishmaniasis in acquired immunodeficiency syndrome: a light and electron microscopic study of two cases.

Institute of Pathology, University Hospital, Lausanne, Switzerland.
Modern Pathology (Impact Factor: 6.36). 11/1996; 9(10):966-9.
Source: PubMed

ABSTRACT An increased incidence of visceral leishmaniasis in patients infected with the human immunodeficiency virus (HIV) is observed in areas in which both infectious diseases are endemic. Intensive worldwide traveling has also resulted recently in an increasing number of leishmanial and HIV coinfections in nonendemic areas. We describe the clinical, light microscopic, and ultrastructural features of two cases of imported, HIV-related, visceral leishmaniasis involving the alimentary tract, including the esophagus, the stomach, the duodenum, the ileum, the colon, and the rectum. We also discuss the differentiation of leishmanial infections from other HIV-related gastrointestinal opportunistic infections.

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    ABSTRACT: In endemic regions, visceral leishmaniasis is one of the most common opportunistic infections in HIV positive patients. Simultaneous infection with Leishmania and HIV has been reported in some countries but this is the first report of such a case in Iran. Our patient was a 27 years old man with intermittent night fever, abdominal pain, loss of appetite, vomiting, watery diarrhea and severe weight loss for 6 months. He had low socio-economic status with an imprisonment history. The patient was quite cachectic and had low grade fever. Physical exam and upper GI endoscopy revealed oropharyngeal candidiasis. Microscopic evaluation of duodenal biopsy material showed Leishmania amastigotes in macrophages of lamina propria. Leishman bodies were also observed in bone marrow aspiration specimen. Serologic tests were positive for Leishmania infantum. HIV antibody was also positive with a CD4+cell count of 80/μl. The diagnosis was acquired immunodeficiency syndrome with simultaneous visceral leishmaniasis involving intestinal mucosa.
    Iranian Red Crescent medical journal. 05/2011; 13(5):348-51.
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    ABSTRACT: Visceral leishmaniasis is a disease caused by a haemoflagellate protozoan of the genus Leishmania. It has a wide geographical spread. Classic cases are found primarily in children and present with typical features that include fever, anaemia, hepatosplenomegaly, hypergammaglobulinaemia, and pancytopenia. The diagnosis is usually achieved by bone marrow smears, culture and serology; however, it can manifest itself atypically, mostly in patients infected with HIV and geriatric immunocompetent patients. We report an unusual case of visceral leishmaniasis diagnosed in a 27 year-old HIV-infected male who presented with abdominal discomfort and diarrhoea of four weeks duration associated with nausea and vomiting, but with no typical symptoms or signs of visceral leishmaniasis. The diagnosis was established through the identification of the Leishmania organism in duodenal and colonic biopsies and confirmed by subsequent bone marrow smears.
    Sultan Qaboos University medical journal 05/2011; 11(2):269-72.
  • Gastroenterología y Hepatología 12/2006; 29(10). · 0.83 Impact Factor