Digestive leishmaniasis in acquired immunodeficiency syndrome: a light and electron microscopic study of two cases.
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.
Article: Gastric disease in AIDS[Show abstract] [Hide abstract]
ABSTRACT: In contrast to the esophagus and colon, the stomach is a less common site for the occurrence of primary opportunistic infections in AIDS. Most gastric opportunistic infections in AIDS occur as part of a generalized gastrointestinal or systemic syndrome (ie, secondary involvement). Besides infections, opportunistic neoplasms such as Kaposi's sarcoma and non-Hodgkin's lymphoma can also involve the stomach in AIDS patients. Since the introduction of highly active antiretroviral therapy, the incidence of gastrointestinal disorders has decreased in HIV-infected patients and the incidence of nonopportunistic gastrointestinal disorders, including Helicobacter pylori infection and peptic ulcer disease, has risen. The main diagnostic tool for AIDS patients with suspected gastric pathology is upper endoscopy with biopsies. The article presents the various gastric pathologies that can occur in AIDS and focuses on their clinical and endoscopic approach.Techniques in Gastrointestinal Endoscopy 04/2002; 4(2):66-70. DOI:10.1053/tgie.2002.33013
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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.05/2011; 13(5):348-51.
Gastroenterología y Hepatología 12/2006; 29(10). DOI:10.1157/13095204 · 0.83 Impact Factor