Disseminated American cutaneous leishmaniasis in a patient with AIDS

Persistent Infections by Leishmania (Viannia) braziliensis

“…This tendency, well documented and fashionable in the AIDS era (Coura et al 1987, Bastuji-Garin et al 1991 was known by the earlier workers in L. braziliensis endemic areas. In fact, Lindenberg (1909) reported among workers laying the tracks for the railroad from the State of São Paulo to Mato Grosso, a high incidence of skin ulcers with slow evolution, difficult to cure and with frequent relapses.…”

“…The existence of cryptic or inapparent infection by Leishmania is revealed in patients affected by AIDS when cutaneous or mucocutaneous lesions appear without a previous history of leishmaniasis (Coura et al 1987, Machado et al 1992. Recently, using a L. braziliensis specific polymerase chain reaction assay (PCR) (Guevara et al 1992) based on ribosomal nontranscribed spacer sequences, we detected parasite DNA on blood samples of a patient who suffered from multiple cutaneous lesions 30 years ago, and was cured spontaneously (Guevara et al 1993).…”

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“…For instance in HIV patients L. (Viannia) braziliensis can cause visceral infections or disseminated skin lesions (Coura et al 1987). Transmission levels may also increase when the vector feeds on immuno-depressed individuals with high parasitaemias (Molina et al 2003).…”

Atypical Mucocutaneous Leishmaniasis Caused by Leishmania braziliensis in an Acquired Immunodeficiency Syndrome Patient: T-cell Responses and Remission of Lesions Associated with Antigen Immunotherapy

“…Leishmania braziliensis is the most common species found parasitizing humans in Brazil. Since 1987, several reports of ATL patients with associated acquired immunodeficiency syndrome (AIDS) have revealed unusual immunophatological aspects of leishmaniasis (Coura et al 1987, Dedet et al 1995. .…”

“…. The majority of patients suffering from Leishmania-human immunodefiency virus (HIV) co-infection have shown atypical clinical pictures such as disseminated cutaneous leishmaniasis (Coura et al 1987, visceral involvement due to dermotropic parasites (Hernandez et al 1993), cutaneous involvement due to viscerotropic parasites (Rubio et al 1997), unusual clinical presentation of cutaneous lesions (Daudén et al 1996, Rubio et al 1997) and mucosal lesions with abundant amastigote forms (Cimmerman & Gomes 1993, Echevarría et al 1993, Sasaki et al 1997. However, those patients may also develop the classical localized cutaneous lesions (Gonzalés-Rupérez et al 1997).…”