Visceral leishmaniasis involving lung and a cutaneous Kaposiʼs sarcoma lesion

Visceral leishmaniasis is hypoendemic in Mediterranean countries, where it is caused by the flagellate protozoan Leishmania infantum. VL cases in this area account for 5%–6% of the global burden. Cases of Leishmania/HIV coinfection have been reported in the Mediterranean region, mainly in France, Italy, Portugal, and Spain. Since highly active antiretroviral therapy was introduced in 1997, a marked decrease in the number of coinfected cases in this region has been reported. The development of new diagnostic methods to accurately identify level of parasitemia and the risk of relapse is one of the main challenges in improving the treatment of coinfected patients. Clinical trials in the Mediterranean region are needed to determine the most adequate therapeutic options for Leishmania/HIV patients as well as the indications and regimes for secondary prophylaxis. This article reviews the epidemiological, diagnostic, clinical, and therapeutic aspects of Leishmania/HIV coinfection in the Mediterranean region.

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“…Amyloid A (AA) amyloidosis leading to renal failure has been associated with chronic VL in HIV patients [37]–[39].…”

Section: Clinical Manifestations Of Visceral Leishmaniasis In Hiv-coimentioning

confidence: 99%

Visceral Leishmaniasis and HIV Coinfection in the Mediterranean Region

Monge‐Maíllo

Norman²,

Cruz³

et al. 2014

PLoS Negl Trop Dis

108

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“…Lower respiratory tract involvement in immunocompetent individuals is rare; interstitial pneumonitis with fibrosis has been reported to occur in only 1 series, involving HIVseronegative persons with New World visceral leishmaniasis but without mediastinal lymphadenopathy [5]. Pulmonary involvement by Leishmania in HIV-infected patients, however, has been described [6][7][8].…”

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confidence: 99%

Bronchopulmonary and Mediastinal Leishmaniasis: An Unusual Clinical Presentation of Leishmania donovani Infection

Marshall

Kropf²,

Murray

et al. 2000

Clinical Infectious Diseases

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We describe a case of unusual leishmaniasis in a Sudanese man with a history of progressively enlarging granulomatous mediastinal lymphadenopathy, worsening hemoptysis, and an intense mucosal granulomatous inflammatory response in the large bronchi. Leishmania donovani DNA was detected in bronchial biopsies by polymerase chain reaction. This is a novel description of human leishmanial infection in an immunocompetent patient involving this anatomical site. The patient's condition improved clinically, spirometrically, and radiologically after a course of treatment with amphotericin B. The cell-mediated immune response was analyzed before, during, and after successful antileishmanial chemotherapy.

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“…Leishmania was first described to affect the lungs of a patient with AIDS in 1991 [16]. Subsequently, it has been described as a cause of pulmonary infiltrates [17], a solitary pulmonary nodule [18], diffuse pulmonary and pleural disease [19,20], lung masses [21], and bronchioloalveolar adenoma [22].…”

Section: Discussionmentioning

confidence: 99%

Visceral Leishmaniasis With Endobronchial Involvement In An Immunocompetent Adult

Kotsifas¹,

Metaxas²,

Takou³

et al. 2010

C51. Unusual Lung and Chest Infections (Case Reports): Horses, Zebras and Unicorns

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Visceral leishmaniasis is characterized by fever, cachexia, hepatosplenomegaly, pancytopenia, and hypergammaglobulinemia. Cough may be a presenting symptom as well. However, pulmonary involvement is considered rare and mainly described in immunocompromised patients. We describe a case of an immunocompetent adult whose clinical presentation was dominated by cough and hemoptysis. Bronchoscopy revealed a discreet polypoid mucosal endobronchial lesion whose biopsy yielded Leishmania amastigotes within histiocytes. Transbronchial needle biopsy of a right paratracheal lymph node was also positive. Leishmania amastigotes were also found on bone marrow and liver biopsies. Treatment with IV Amphotericin B was successful. In conclusion, cough should not be overlooked as a presenting symptom of visceral leishmaniasis and may be a sign of pulmonary involvement.

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Visceral leishmaniasis involving lung and a cutaneous Kaposiʼs sarcoma lesion

Cited by 41 publications

References 0 publications

Visceral Leishmaniasis and HIV Coinfection in the Mediterranean Region

Visceral Leishmaniasis and HIV Coinfection in the Mediterranean Region

Bronchopulmonary and Mediastinal Leishmaniasis: An Unusual Clinical Presentation of Leishmania donovani Infection

Visceral Leishmaniasis With Endobronchial Involvement In An Immunocompetent Adult

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