Identification of Leishmania chagasi from skin in Leishmania/HIV co-infection: a case report

HIV/AIDS-associated visceral leishmaniasis in patients from an endemic area in Central-west Brazil

“…Enlargement of the liver and especially the spleen seems to be less frequent in VL-HIV/AIDS patients than in VL patients without AIDS (Pintado et al 2001) and this enlargement may be associated with a deficient proliferative response of mononuclear cells in these organs (Peters et al 1990). Atypical manifestations at unusual anatomic sites such as skin, gastrointestinal tract or lungs (Orsini et al 2002, Herrejón et al 2005 were not observed in this study.…”

“…The endemicity of VL in many Brazilian regions is high, but few reports have addressed the clinical features of HIV/AIDS-associated VL (Borges et al 1999, Orsini et al 2002, Rabello et al 2003, Daher et al 2009). Although the HIV/AIDS National Surveillance Program has been considered a success, HIV is still spreading in Brazil and reaching small cities; also, an urbanization of human leishmaniasis has been observed, resulting in an overlap of these two diseases (Rabello et al 2003).…”

L. (L.) chagasi in aids and visceral leishmaniasis (kala-azar) co-infection

“…The description of granulomatous inflammatory infiltration with giant cells favors the presence of leishmanias' DNA inside macrophages, despite the fact that amastigotes forms had not been visualized on histopathological exam. In that approach, ORSINI et al (2002) 16 also demonstrated the identification of L. (L.) chagasi in extracted DNA from parasites cultivated from skin lesion sample. One more reason to justify the positive PCR for leishmania on skin sample could be endorsed by the response to antimonial treatment, with cicatrization of ecthymatous skin lesions.…”

“…In Brazil, reports of cutaneous lesions attributed to leishmaniasis in aids-VL co-infection are scarce 16 . Probably it happens because the lesions may shape common dermatoses, such as dermatofibroma, lichen, drug eruption 4 .…”

“…When cutaneous compromising exists in VL, in general it happens in association with aids coursing with low count of CD4 T cells 4,8,10,16 . Classic PKDL due to L. (L.) chagasi is not commonly described in Brazil 3 .…”