Visceral leishmaniasis caused by Leishmania (Viannia) braziliensis in a patient infected with human immunodeficiency virus

Abstract

The current article reports the case of a 19-month-old-girl, from the state of Minas Gerais, Brazil, with visceral leishmaniasis, by Leishmania (Viannia) braziliensis, and Human Immunodeficiency Virus (HIV) co-infection. The child's mother and father, aged 22 and 27 years old, respectively, were both HIV positive. The child was admitted to the General Pediatric Center, in Belo Horizonte, presenting high fever, fatigue, weight loss and enlargement of liver and spleen. Indirect immunofluorescent test revealed a titer of 1:320 for Leishmania. Such result was confirmed by the presence of amastigotes in bone marrow aspirate samples and culture of promastigote forms. Parasites were identified as being Leishmania (Viannia) braziliensis through PCR, using a L. braziliensis complex primer and a generic primer, followed by hibridization. Specific leishmaniasis therapy (Glucantime register mark or target antimonial) was intravenously administered.

Drug Uptake and Modulation of Drug Resistance in Leishmania by an Aquaglyceroporin

“…We have recently observed that Sb(III)-resistant amastigotes of L. panamensis and L. infantum are crossresistant to Sb(V) when grown inside of macrophages, whereas Sb(III) is highly leishmanicidal against both forms of the parasite. 2 Previous studies found no correlation between clinical response and in vitro resistance to Sb(V) with the promastigote stage of the parasite (31); however, a correlation was observed with intracellular parasites (31). Interestingly, we also observed a correlation between resistance to Sb(III) and to As(III) in both promastigotes and intracellular amastigotes (Table II).…”

“…The mechanisms of resistance in some of these strains have been determined, and there is considerable diversity in the causes of resistance (37). 2 This suggests that increasing expression of AQP1 can reverse resistance in diverse backgrounds of resistance. …”

“…Leishmaniasis is a spectrum of diseases in which each disease is distinctly manifested, and all have potentially devastating consequences: disfigurement, damage to internal organs, and death (1). In the last two decades, visceral leishmaniasis especially has been widely recognized as an opportunistic infection in immunocompromised patients, particularly those who are infected with human immunodeficiency virus (1,2). The first line choice of treatment against all forms of leishmaniasis uses drugs containing pentavalent antimony such as sodium stibogluconate (Pentostam) and meglumine antimonate (Glucantime).…”

Identificação de espécies de Leishmania isoladas de casos humanos em Mato Grosso do Sul por meio da reação em cadeia da polimerase

“…A identificação das espécies de Leishmania que circulam em determinado foco de transmissão, particularmente em regiões onde as diferentes formas clínicas ocorrem simultaneamente, é muito importante para o conhecimento da epidemiologia das leishmanioses e planejamento de estratégias de controle 2 . Tratando-se de leishmaniose visceral nas Américas, a única espécie considerada responsável pela doença é Leishmania (Leishmania) chagasi, embora já se tenha descrito Leishmania (Leishmania) amazonensis 5 e Leishmania (Viannia) braziliensis 48 49 52 , em diagnóstico humano 47 , canino 20 44 e em flebotomíneos 24 35 36 , sendo também útil na caracterização de isolados humanos 37 .…”

Co-infecção HIV/Leishmania: manifestações clínicas em uma série de casos

“…São 11 as espécies de Leishmania identificadas como patogênicas para o homem e estão relacionadas a acometimento de tegumentos ou vísceras, porém em alguns casos descritos em pacientes imunodeprimidos, se encontra acometimento de pele na leishmaniose visceral (Francês et al, 1984;Postigo et al, 1990;Russo et al, 2003), assim como raros casos de disseminação a vísceras a partir de lesões tegumentares (Silva et al, 2002).…”