Para-kala-azar dermal leishmaniasis in a patient in Brazil: a case report

Abstract

Visceral leishmaniasis is common in Brazil and is caused by Leishmania (Leishmania) infantum/chagasi. Post-kala-azar dermal leishmaniasis frequently follows visceral leishmaniasis caused by L. donovani, and para-kala-azar dermal leishmaniasis refers to an uncommon presentation wherein it occurs simultaneously along with visceral leishmaniasis. While post-kala-azar dermal leishmaniasis only occurs occasionally in L. infantum/chagasi infections, it frequently occurs in patients with concomitant immunosuppression (HIV co-infection). Here, we describe the first case of para-kala-azar dermal leishmaniasis in Brazil. It is important to raise awareness of post-and para-kala-azar dermal leishmaniasis in L. infantum endemic areas as these patients may contribute to visceral leishmaniasis transmission.

An unusual case of post-kala-azar dermal leishmaniasis in a patient with HIV and visceral leishmaniasis co-infection

“…5 Skin lesions have been described in patients with HIV-VL co-infection, and Leishmania amastigotes have been detected in healthy looking skin. 7 There are few reports of PKDL with L. infantum in PLWH, [8][9][10] and in some patients, PKDL can occur while the patient is still on treatment for VL; this is sometimes termed 'para-kala-azar dermal leishmaniasis'. 11 The optimum management of VL with HIV co-infection is not known.…”

Diversidade clínica e tratamento da leishmaniose visceral

“…Afora estas manifestações pouco usuais, pode-se observar também lesões ulceradas por L. infantum 20 . Recentemente, Lindoso et al 21 descreveram a leishmaniose dérmica para-kala-azar (Figura 2E), caracterizada por manifestação cutânea, tipo pápulas e máculas, associada a manifestação visceral.…”