Diagnosis of visceral leishmaniasis in HIV-infected individuals using peripheral blood smears.
OBJECTIVE
To compare the clinical and laboratory features of visceral leishmaniasis (kala-azar) in HIV-infected and non-infected subjects, and to determine the presence of Leishmania amastigotes in circulating leukocytes using peripheral blood smears.


METHODS
Twenty-eight HIV-infected and six HIV-negative adult patients diagnosed as having kala-azar presenting at one institution over a 7-year period.


METHODS
Retrospective review of clinical charts and re-examination of peripheral blood smears.


RESULTS
There were no significant differences in the clinical presentation and laboratory features of HIV-positive and HIV-negative patients. However, Leishmania amastigotes were observed in circulating leukocytes in eight out of the 17 available peripheral blood smears (15 from HIV-infected patients). All eight individuals presenting with Leishmania in peripheral blood leukocytes were HIV-positive.


CONCLUSIONS
Direct visualization of Leishmania amastigotes in leukocytes on peripheral blood smears enabled the diagnosis of kala-azar in a high proportion [eight out of 15 (53%)] of our HIV-infected patients.
Martínez
P
P
Sección de Hematología y Bioquímica, Instituto de Salud Carlos III, Madrid, Spain.
de la Vega
E
E
Laguna
F
F
Soriano
V
V
Puente
S
S
Moreno
V
V
Sentchordi
M J
MJ
García-Aguado
C
C
González-Lahoz
J
J
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000469:parasitology; D000328:Adult; D000818:Animals; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007893:Leishmania donovani / Q000302:isolation & purification; D007898:Leishmaniasis, Visceral / Q000150:complications* / Q000175:diagnosis* / Q000469:parasitology; D007962:Leukocytes / Q000469:parasitology; D008297:Male; D008875:Middle Aged