Tratamiento con anfotericina B liposomal en tres pacientes inmunodeprimidos con leishmaniasis visceral

Visceral leishmaniasis in hematopoietic stem cell transplantation

“…It should be noted that in three cases (75%), granulocyte intracellular Leishmania amastigotes were seen in peripheral blood smears. This fact, which has previously been observed in other immunocompromised individuals, such as those infected by HIV, constitutes a very useful diagnostic tool [7,8]. The sensitivity of Lesihmania PCR in bone marrow ranges between 70% and 90% which could explain the negative result in our patient [6,13,14].…”

“…Three cases of LV in HSCT patients have been previously reported [7–9]. Two patients received allogenic, and one patient autologous, HSCT.…”

“…Moreover, the number of cases of VL in endemic regions is significantly lower in HSCT recipients than in other immunocompromised patients, such as kidney transplant recipients [10]. The low rate of VL (and other infections, such as tuberculosis) in HSCT suggests that some unknown factor, other than the degree of cell‐mediated immunosuppression, may have a role in the pathogeny of opportunistic infections in transplant patients [7–9].…”

“…The information obtained during the present study does not allow us to make definitive recommendations about the indication of secondary prophylaxis. In any case, the tendency of VL relapse in immunocompromised patient infections may support the recommendation of secondary prophylaxis [7].…”