CC BY-NC-ND 4.0 · J Lab Physicians 2011; 3(02): 119-121
DOI: 10.4103/0974-2727.86847
Case Report

Atypical Presentation of Visceral Leishmaniasis in a HIV-positive Patient from a Nonendemic Area

Dhara H Vyas
Department of Microbiology, Smt. N. H. L. Municipal Medical College, Ellisbridge, Ahmedabad, India
,
Parul D Shah
Department of Microbiology, Smt. N. H. L. Municipal Medical College, Ellisbridge, Ahmedabad, India
› Author Affiliations
Source of Support: Nil

ABSTRACT

Visceral leishmaniasis (VL), though widely prevalent in India, is not seen in the Rajasthan where the dry, hot and arid climatic conditions create a hostile environment for the growth of the parasite or its vector, the sandfly. We present a case of VL in a patient co-infected with HIV from this region. A 34-year-old known case of a HIV-positive patient presented to the skin department of our hospital with multiple, nontender, erythematous, papulonodular lesions all over the body for 6 months with history of weight loss and low-grade fever. Important examination findings were pallor, inguinal lymphadenopathy and hepatosplenomegaly. Laboratory findings included anemia, leucopenia, hypergammaglobulinemia and altered leucocytes to erythrocyte ratio. Buffy coat examination and bone marrow aspirates showed the presence of leishman bodies inside monocytes and macrophages respectively as well as extracellularly also. The patient was treated with amphotericin B intravenously and responded well to the treatment.



Publication History

Article published online:
09 May 2020

© 2011.

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  • REFERENCES

  • 1 Mc Adam AJ, Sharpe AH. Infectious diseases. In: Robbins and Cotran, editors. Pathologic Basis of Disease. 7th ed. New Delhi: Elsevier Publishers; 2004 .p. 403-5.
  • 2 Arevalo, J. Influence of Leishmania (viannia) species on the response to antimonials treatment in patients with American tegumentary leishmaniasis. J Infect Dis 2007;195:1846-51.
  • 3 Kesavan A, Parvathy VK, Thomas S, Sudha SP. Indigenous visceral leishmaniasis: two cases from Kerala. Indian J Pediatr 2003;40:373-4.
  • 4 Redhu NS, Dey A, Balooni V, Singh S. Leishmania-HIV co-infection: an emerging problem in India. AIDS 2006;20:1213-5.
  • 5 Desjeux P. Leishmaniasis: current situation and new perspectives. Comp Immunol Microbiol Infect Dis 2004;27:305-18.
  • 6 World Health Organization. Report of the consultative meeting on Leishmania/HIV co-infection.Vol.95. Geneva: WHO/LEISH; 1995. p. 1-14.
  • 7 ter Horst R, Collin SM, Ritmeijer K, Bogale A, Davidson RN. Concordant HIV infection and visceral leishmaniasis in Ethiopia: the influence of antiretroviral treatment and other factors on outcome. Clin Infect Dis 2008;46:1702-9.
  • 8 Olivier M, Badarό R, Medrano FJ, Moreno J. The pathogenesis of Leishmania/HIV co-infection: cellular and immunological mechanisms. Ann Trop Med Parasitol 2003;97(Suppl 1):79-98.
  • 9 Singh S. Mucosal Leishmaniasis in an Indian AIDS patient. Lancet Infect Dis 2004;4:660-1.
  • 10 Singh S, Kumar J, Singh R, Dwivedi SN. Hepatitis B and C viral infections in Indian kala-azar patients receiving injectable anti--leishmanial drugs: a community-based study. Int J Infect Dis 2000;4:203-8.
  • 11 Malafaia G. Coinfection HIV/Leishmania: a serious problem of Public Health. Rev Saude Publica 2009; 43:195.
  • 12 Alvar J, Aparicio P, Aseffa A, Den Boer M, Caňavate C, Dedet JP, et al . The relationship between leishmaniasis and AIDS: the second 10 years. Clin Microbiol Rev 2008;21:334-59.