Pulmonary involvement in human visceral leishmaniasis: Clinical and tomographic evaluation

Abstract

Visceral leishmaniasis (VL) is a severe, systemic and potentially lethal parasitosis. The lung, like any other organ, can be affected in VL, and interstitial pneumonitis has been described in past decades. This research aimed to bring more recent knowledge about respiratory impairment in VL, characterizing pulmonary involvement through clinical, radiographic and tomographic evaluation. This is an observational, cross-sectional study that underwent clinical evaluation, radiography and high-resolution computed tomography of the chest in patients admitted with the diagnosis of VL in a university service in Northeast Brazil, from January 2015 to July 2018. The sample consisted of 42 patients. Computed tomography was considered abnormal in 59% of patients. Images compatible with pulmonary interstitial involvement were predominant (50%). The most observed respiratory symptom was cough (33.3%), followed by tachypnea (14.1%). Chest radiography was altered in only four patients. VL is a disease characterized by systemic involvement and broad spectrum of clinical manifestations. The respiratory symptoms and tomographic alterations found show that the involvement of respiratory system in VL deserves attention because it is more common than previously thought. Chest X-ray may not reveal this impairment.

Bronchoscopy and Lung Fine-Needle Aspiration for Antemortem Evaluation of Pulmonary Involvement in Dogs with Naturally Occurring Canine Leishmaniosis

“…Noteworthily, almost half of the dogs showed positive BALF IFAT and positive serum IFAT, which could be the result of immune response of the lungs, reflecting their susceptibility to the disease in certain dogs [ 2 ]. Local production of immunoglobulins in the lungs has been previously demonstrated in BALF, in human patients with fungal, bacterial, and allergic lung conditions [ 42 , 43 , 44 ] but never before in dogs with CanL. Dilution of the BALF to a variable and unpredictable degree during sampling may have had a negative impact on the positivity of IFAT.…”

Epidemiological characterization and spatial distribution of visceral leishmaniasis cases in Três Lagoas - MS, Brazil in the period of 2007-2021

“…Interestingly, cough was observed in over half of patients, similar with that one found by Almeida et al (2020). This phenomenon is explained by the thoracoabdominal organ compromising, causing greater abdominal volume, responsible for adaptations in respiratory mechanics, which can trigger respiratory symptoms such as dyspnea and cough (Silva et al, 2013;Bispo et al, 2020).…”

Utility of chest imaging in the diagnosis and management of patients with visceral leishmaniasis: A systematic review

“…Most of the included studies were case reports and one study followed a cross-sectional design. [33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49] The majority of the studies came from India, southern European countries, and Brazil. The studies included 59 patients with a mean age (standard deviation) of 40.3 (±5.9) years, with males predominating (74.5%; 44) and 20% (12) patients co-infected with HIV/AIDS and immunocompromised.…”