Bronchopulmonary and mediastinal leishmaniasis: an unusual clinical presentation of Leishmania donovani infection.
We describe a case of unusual leishmaniasis in a Sudanese man with a history of progressively enlarging granulomatous mediastinal lymphadenopathy, worsening hemoptysis, and an intense mucosal granulomatous inflammatory response in the large bronchi. Leishmania donovani DNA was detected in bronchial biopsies by polymerase chain reaction. This is a novel description of human leishmanial infection in an immunocompetent patient involving this anatomical site. The patient's condition improved clinically, spirometrically, and radiologically after a course of treatment with amphotericin B. The cell-mediated immune response was analyzed before, during, and after successful antileishmanial chemotherapy.
Marshall
B G
BG
Department of Respiratory Medicine (National Heart and Lung Institute), Imperial College School of Medicine, London, England.
Kropf
P
P
Murray
K
K
Clark
C
C
Flanagan
A M
AM
Davidson
R N
RN
Shaw
R J
RJ
Müller
I
I
D000328:Adult; D000818:Animals; D001980:Bronchi / Q000469:parasitology / Q000473:pathology; D001982:Bronchial Diseases / Q000469:parasitology* / Q000473:pathology; D016054:DNA, Protozoan / Q000032:analysis; D006099:Granuloma / Q000469:parasitology / Q000473:pathology; D006801:Humans; D007893:Leishmania donovani / Q000302:isolation & purification*; D007896:Leishmaniasis / Q000469:parasitology / Q000473:pathology*; D008206:Lymphatic Diseases / Q000469:parasitology / Q000473:pathology; D008297:Male; D008477:Mediastinal Diseases / Q000469:parasitology* / Q000473:pathology; D008482:Mediastinum / Q000469:parasitology* / Q000473:pathology; D016133:Polymerase Chain Reaction; D013397:Sudan
D016054:DNA, Protozoan