Duodenal leishmaniasis in a HIV patient

Abstract

We report the case of a 31-year-old male who was diagnosed with HIV infection eleven years ago. At this moment his disease is in stage C3. He consulted because of watery diarrhea with no pathologic products for the last 5 months. He also reported continual abdominal pain unrelated to food ingestion. Over those months he lost about 7-8 kg of body weight, and some skin nodes developed in different parts of his body. Laboratory parameters were nonspecific in the first study. Antibodies against Leishmania, CMV, syphilis, HBV, and HCV were all negative. Blood and stool cultures and parasite tests were all negative, too. A biopsy was obtained from skin nodes, which was positive for Leishmania, and a digestive endoscopy was carried out, which showed a paved, nodular mucosa all over the duodenum, from which we took several biopsies (Figs. 1 and 2). A histological study revealed a clear, severe infiltration of duodenal villi by macrophages filled with Leishmania bodies (Fig. 3). Diagnosis: malabsorption due to visceral leishmaniasis with skin and small-bowel infiltration in a HIV patient. DISCUSSION Leishmaniasis is a parasitic disease transmitted by the biting of Phlebotomus, a kind of mosquito, and caused by different species of Leishmania. There are three forms of presentation: skin nodes (caused by Leishmania tropica), mucocuta

Concomitant BK virus infection and visceral Leishmaniasis in a pediatric liver transplant recipient

“…Bone marrow aspiration and biopsy was reported to be nor- of intestinal leishmaniasis in the literature. Most of the reported cases were in immune-compromised patients, including concomitant Human Immune deficiency Virus (HIV) infection [15][16][17][18] and systemic lupus erythematous. 19 The only encountered post-LT intestinal leishmaniasis was a report by Araujo et al in a 17-year-old Brazilian man who presented with weight loss and chronic diarrhea.…”

The Role of F-18 FDG PET in the Diagnosis of Visceral Leishmaniasis: Two Case Reports

“…Additionally, if at the beginning there was no fever and only moderate splenomegaly, VL should have been considered since the gastrointestinal location is relatively common in HIV-positive individuals [11]. However, in 90% of patients with acquired immunodeficiency syndrome, the location is duodenal and causes dysphagia, diarrhea, or abdominal pain [12][13][14].…”

Unusual endoscopic findings in an immunosuppressed patient

“…Treatment with meglumine antimoniate was initiated owing to previous failure with liposomal amphotericin B, without response. Some cases of visceral leishmaniasis showing non-specific findings (atrophy, edema, and whitish nodular mucosa) on esophagogastroduodenoscopy have been reported [1,2], with the mucosa appearing normal in up of 45 % of cases [3,4]. There is only one case reporting VCE findings of visceral leishmaniasis in an immunocompromised patient with a diffuse intestinal atrophic pattern [5].…”