A case of panuveitis with hypopyon due to presumed ocular leishmaniasis in a HIV patient

Couture, Simon; Agrawal, Rupesh; Woods, Kate; Lockwood, Diana N J; Pavésio, Carlos; Addison, Peter

doi:10.1186/s12348-014-0021-0

Cited by 5 publications

(6 citation statements)

References 15 publications

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“…The majority of patients were men (86.1%), with a median age of 35.5 years (IQR 29.5–42). Group 1 ([6,10–25], cases 1 and 3) included 20 patients (55.6%), group 2 ([23,26–36], case 2) included 16 patients (44.4%). Patients from group 1 originated mostly from Europe, whereas patients from group 2 were mostly from Central or South America, East Africa and India.…”

Section: Resultsmentioning

confidence: 99%

Immune recovery-related patterns of post kala-azar dermal and ocular leishmaniasis in people living with HIV

Rousset

Zenou

Saunier³

et al. 2022

Aids

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Objective:Post kala-azar dermal leishmaniasis (PKDL) is a rare complication of visceral leishmaniasis. We aimed at reporting PKDL cases in people living with HIV (PLHIV) and compare their characteristics based on whether PKDL occurred in the context of immune recovery under antiretroviral therapy (ART) or not.Design:National survey and literature review.Methods:We called for observations in France in October 2020 and performed a literature review from PubMed (Medline) and Web of Science up to December 2020. Two groups of patients were defined based on whether PKDL occurred in the context of immune recovery under ART (group 1) or not (group 2), and compared.Results:Three PLHIV with PKDL identified in France in the last decade were described and added to 33 cases from the literature. Compared with group 2 (16/36, 44.4%), patients from group 1 (20/36, 55.6%) originated more frequently from Europe (12/20, 60% vs. 2/16, 12.5%; P = 0.0038), had higher median blood CD4+ cell counts (221/μl vs. 61/μl; P = 0.0005) and increase under ART (122/μl, interquartile range 73–243 vs. 33/μl, interquartile range 0–53; P = 0.0044), had less frequently concomitant visceral leishmaniasis (3/20, 15% vs. 8/12, 66.7%; P = 0.006), and a trend to more frequent ocular involvement (7/20, 35% vs. 1/16, 6.25%; P = 0.0531).Conclusion:In PLHIV, PKDL occurs after a cured episode of visceral leishmaniasis as part of an immune restoration disease under ART, or concomitant to a visceral leishmaniasis relapse in a context of AIDS. For the latter, the denomination ‘disseminated cutaneous lesions associated with visceral leishmaniasis’ seems more accurate than PKDL.

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Section: Resultsmentioning

confidence: 99%

Immune recovery-related patterns of post kala-azar dermal and ocular leishmaniasis in people living with HIV

Rousset

Zenou

Saunier³

et al. 2022

Aids

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“…A change in immune response from a Th2 to a combined Th1/Th2 pattern underlines ocular leishmaniasis after VL treatment resulting in blepharo-conjunctivitis or pan-uveitis [ 71 ]. In HIV–VL co-infected patients, ocular leishmaniasis is postulated to be a part of highly active antiretroviral therapy (HAART)-induced immune reconstitution syndrome [ 72 ]. Reports of ocular disorders including rare cases of unilateral and bilateral blindness, permanent in some cases, ulcerative keratitis, leukocoria, blurred vision, ocular hyperaemia, photophobia and eye pain, in patients treated with miltefosine for PKDL have mostly originated from India [ 73 ].…”

Section: Atypical Presentations Of Leishmaniasismentioning

confidence: 99%

Unusual Observations in Leishmaniasis—An Overview

et al. 2023

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Leishmaniasis significantly affects the population of the tropics and subtropics. Clinical features and infective species of Leishmania are the primary factors driving the direction of diagnosis. The rise in incidences of atypical presentations present a challenge in patient treatment. Knowledge of unusual/rare presentations can aid in having a broader perspective for including the different aspects during the examination and thus avoid misdiagnosis. A comprehensive literature survey was performed to present the array of atypical presentations confounding clinicians which have been seen in leishmaniasis. Case reports of unusual findings based on the localizations and morphology of lesions and infective species and the predominant geographical sites over almost five decades highlight such presentations in the population. Information regarding the clinical features recorded in the patient and the chosen treatment was extracted to put forward the preferred drug regimen in such cases. This comprehensive review presents various unusual observations seen in visceral leishmaniasis, post-kala-azar dermal leishmaniasis, cutaneous leishmaniasis, and mucocutaneous leishmaniasis. It highlights the need to consider such features in association with differential diagnosis to facilitate proper treatment of the patient.

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“…These patients often show relapse after treatment. 18,19 Ocular affection may be sight threatening. In the skin, the lesions are swelling, papule, plaque, nodule or ulcer.…”

Section: Leishmaniamentioning

confidence: 99%

Parasitic Eye Disease in India and the World- A Major Review

Sarkar¹,

Bhattacharayya²,

Choudhuri³

et al. 2017

jemds

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BACKGROUNDParasites are a group of eukaryotic organisms. They may be free living, may form symbiotic relationships or form parasitic relationships with the hosts. The total number of recognised species of parasites are over 800,000. They may be unicellular or multicellular. Unicellular parasites include protozoa, while multicellular parasites include helminths and arthropods. The parasites are associated with human beings since the beginning of civilisation. The parasitic diseases are present worldwide including India. In addition to the already prevalent diseases, newer diseases are emerging in the clinical scenario. The systemic diseases like cysticercosis, paragonimiasis, hydatidosis and toxoplasmosis are common. Acquired toxoplasma infections are rising in incidence in immunodeficient individuals. Cestodes, trematodes, tissue flagellates and sporozoa affect human beings commonly including their eyes in different parts of the world. They thus constitute a real health problem globally. The basics of parasitology lie in morphological and pathological studies. This scope has extended further with recent updates in molecular parasitology. The present review discusses the principal ocular parasites found in India and the world with reference to microbiological and pathological aspects and gives outlines of management.

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A case of panuveitis with hypopyon due to presumed ocular leishmaniasis in a HIV patient

Cited by 5 publications

References 15 publications

Immune recovery-related patterns of post kala-azar dermal and ocular leishmaniasis in people living with HIV

Immune recovery-related patterns of post kala-azar dermal and ocular leishmaniasis in people living with HIV

Unusual Observations in Leishmaniasis—An Overview

Parasitic Eye Disease in India and the World- A Major Review

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