Produção Nacional
Revisado por pares
Atypical Lesions as a Sign of Cutaneous Dissemination of Visceral Leishmaniasis in a Human Immunodeficiency Virus–Positive Patient Simultaneously Infected by Two Viscerotropic Leishmania Species
2011; American Society of Tropical Medicine and Hygiene; Volume: 85; Issue: 1 Linguagem: Inglês
10.4269/ajtmh.2011.10-0398
ISSN1476-1645
AutoresJoanna Reis Santos-Oliveira, Alda Maria Da‐Cruz, Layla Pires, Elisa Cupolillo, Katrin Kuhls, Carmem Beatriz Wagner Giacoia-Gripp, Manoel P. Oliveira-Neto,
Tópico(s)Trypanosoma species research and implications
ResumoLeishmaniasis is considered an emerging opportunistic disease in human immunodeficiency virus (HIV)-infected patients who have considerably variable clinical presentation. We report a patient with visceral leishmaniasis who had unexpected clinical aspects (atypical cutaneous lesions appearing after long-term evidence of visceral parasites). The patient had hepatoesplenomegaly in the absence of fever, but was otherwise generally healthy. The HIV viral load was low despite severe immunossupression (low lymphocyte proliferation and low level of interferon-γ, concomitant with a high lymphocyte activation status). Surprisingly, two Leishmania strains were isolated from his bone marrow (typical L. infantum sequence MON-1, type A) and skin (L. donovani MON-2 sequence); this second strain had not been previously identified in Brazil. The association of visceral leishmaniasis and HIV/acquired immunodeficiency syndrome is a largely unknown disease, particularly in areas in which leishmaniasis is not endemic. Such atypical cases indicate that this disease can be undiagnosed in clinical settings.
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