Generalized cutaneous leishmaniasis in acquired immunodeficiency syndrome

Rosatelli, Jacy Berti; Souza, Cacilda da Silva; Soares, Fernando Augusto; Foss, Norma T.; Roselino, Ana Maria Ferreira

doi:10.1016/s0926-9959(98)00014-2

Cited by 9 publications

(9 citation statements)

References 10 publications

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“…The worsening of clinical manifestations, multiple lesions and high degree of relapses post-treatment in ATL patients co-infected with HIV were previously described ( Rosatelli et al, 1998 ; Puig and Pradinaud, 2003 ; Lindoso et al, 2009 , 2016 ; Giavedoni et al, 2015 ; Calvopina et al, 2017 ). In a study of fifteen cases of AIDS/TL, Lindoso et al (2009) observed mucosal lesions progress in 80% of the patients, disseminated lesions in 60% and genital lesions in 27% of the patients.…”

Section: The Host Point Of Viewmentioning

confidence: 72%

The Binomial Parasite-Host Immunity in the Healing Process and in Reactivation of Human Tegumentary Leishmaniasis

2018

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Leishmaniasis is a vector-borne infectious disease caused by different species of protozoa from the Leishmania genus. Classically, the disease can be classified into two main clinical forms: Visceral (VL) and Tegumentary (TL) leishmaniasis. TL is a skin/mucosal granulomatous disease that manifests mainly as cutaneous localized or disseminated ulcers, papules diffusely distributed, mucosal lesions or atypical lesions. Once the etiology of the infection is confirmed, treatment can take place, and different drugs can be administered. It has already been shown that, even when the scar is clinically evident, inflammation is still present in the native tissue, and the decrease of the inflammatory process occurs slowly during the 1st years after clinical healing. The maintenance of residual parasites in the scar tissue is also well documented. Therefore, it is no longer a surprise that, under some circumstances, therapeutic failure and/or lesion reactivation occurs. All over the years, an impressive amount of data on relapses, treatment resistance and lesion reactivation after healing has been collected, and several factors have been pointed out as having a role in the process. Different factors such as Leishmania species, parasite variability, Leishmania RNA virus 1, parasite load, parasite persistence, age, nutritional status, gender, co-morbidities, co-infection, pregnancy, immunosuppression, lesion duration, number and localization of lesions, drug metabolism, irregular treatment and individual host cellular immune response were described and discussed in the present review. Unfortunately, despite this amount of information, a conclusive understanding remains under construction. In addition, multifactorial influence cannot be discarded. In this context, knowing why leishmaniasis has been difficult to treat and control can help the development of new approaches, such as drugs and immunotherapy in order to improve healing maintenance. In this sense, we would like to highlight some of the findings that may influence the course of Leishmania infection and the therapeutic response, with an emphasis on TL.

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Section: The Host Point Of Viewmentioning

confidence: 72%

The Binomial Parasite-Host Immunity in the Healing Process and in Reactivation of Human Tegumentary Leishmaniasis

2018

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“…[6][7][8][9][10][11][12][13] However, reports on clinical manifestations of tegumentary leishmaniasis in HIV-infected patients are scarce. The lesions described so far range from isolated papules, plaques or ulcers on exposed areas similar to those found in nonimmunosuppressed patients or in nonHIVinfected patients 7,14,15 to disseminated ulcers or plaques.…”

Section: Discussionmentioning

confidence: 99%

Unusual manifestations of tegumentary leishmaniasis in AIDS patients from the New World

Lindoso

Barbosa

Vergara

et al. 2009

British Journal of Dermatology

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“…Poor response to therapy could be secondary to severe immunodepression and suboptimal therapy. Currently, the standardized treatment of CL for immunocompetent patients is either intralesional or systemic antimonials, and HIV-infected patients have also shown a good response to antimonials [ 13 ]. Liposomal amphotericine B has also been found to be effective [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Cutaneous leishmaniasis in a severely immunocompromised HIV patient in Kumbo, Northwest region of Cameroon: case report

Tangie

Desmond²,

Aminde

et al. 2017

BMC Res Notes

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BackgroundLeishmaniasis is a rising opportunistic infection in individuals with human immunodeficiency virus (HIV). Cases of leishmania and HIV co-infection have been documented in several countries in the world with most reporting on the association between visceral leishmaniasis (VL) and HIV. We herein report the case of cutaneous leishmaniasis (CL) occurring in an HIV seropositive patient.Case presentationA 28 year old Cameroonian female diagnosed with HIV for 6 months earlier, presented to our facility with a 3 months history of non-painful rash. Clinical examination revealed non prurigeneous papulo-nodular lesions on the face and thighs which later became crusty ulcerative lesions. Giemsa staining with examination under oil objective immersion identified amastigotes and a diagnosis of CL was made which was managed with amphotericine B (1 mg/kg of body weight) for 14 days with mild improvement of lesions. Patient developed hypokalemia due to the amphotericine B during admission which was corrected and died 1 month after discharge.ConclusionsCurrent evidence suggest higher incidence of VL in HIV, however we report the occurrence of CL in HIV. A high index of suspicion for CL is warranted among clinicians in Africa when faced with HIV patients with inconsistent cutaneous rash.

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Generalized cutaneous leishmaniasis in acquired immunodeficiency syndrome

Abstract: The immunosuppression due to HIV/AIDS seen in this patient may explain the dissemination of the lesions, but the positive specific response to leishmanial antigen may explain the good response to the antimonial treatment.

Cited by 9 publications

References 10 publications

The Binomial Parasite-Host Immunity in the Healing Process and in Reactivation of Human Tegumentary Leishmaniasis

The Binomial Parasite-Host Immunity in the Healing Process and in Reactivation of Human Tegumentary Leishmaniasis

Unusual manifestations of tegumentary leishmaniasis in AIDS patients from the New World

Cutaneous leishmaniasis in a severely immunocompromised HIV patient in Kumbo, Northwest region of Cameroon: case report

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