Leishmania infantum leishmaniasis in corticosteroid--treated patients.
BACKGROUND
The number of leishmaniasis cases associated with immunosuppression has increased regularly over the past 20 years. Immunosuppression related to HIV infection, immunosuppressive treatment, organ transplantation, and neoplastic diseases increases the risk for Leishmania-infected people to develop visceral illness.


METHODS
Three cases of Leishmania infantum leishmaniasis in corticosteroid (CS)-treated patients are reported: an isolated lingual leishmaniasis in a farmer treated with CS for asthma, a severe visceral leishmaniasis associated with cutaneous lesions in a woman with myasthenia gravis, and a visceral involvement after cutaneous leishmaniasis in a man receiving CS.


CONCLUSIONS
Physicians should recognise CS-treated patients as a population likely to be immune-suppressed. In immunodeficiency conditions, unusual forms of leishmaniasis can develop and foster the risk of a diagnostic delay and of poor response to therapy.
Pittalis
Silvia
S
National Institute for Infectious Diseases IRCCS L, Spallanzani Rome Italy. pittalis@inmi.it <pittalis@inmi.it>
Nicastri
Emanuele
E
Spinazzola
Francesco
F
Ghirga
Piero
P
De Marco
Michele
M
Paglia
Maria Grazia
MG
Narciso
Pasquale
P
D000305:Adrenal Cortex Hormones / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use; D000368:Aged; D000818:Animals; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D018314:Leishmania infantum / Q000302:isolation & purification*; D007898:Leishmaniasis, Visceral / Q000139:chemically induced / Q000188:drug therapy / Q000276:immunology* / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D018417:Th1 Cells / Q000187:drug effects / Q000276:immunology
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents