Diffuse skin spread of HIV-associated visceral leishmaniasis: cumbersome diagnostic and therapeutic issues.
An infrequent and atypical case report of HIV-associated visceral leishmaniasis complicated by a diffuse, aspecific maculo-papular cutaneous involvement was characterized by a prolonged course, and a lack of response to repeated attack/maintenance cycles performed with liposomal amphotericin B, despite a satisfactory immune response maintained thanks to a concurrent, potent combination antiretroviral treatment. Only a very prolonged administration of the older i.v. pentamidine isethionate together with oral paromomycin led to a slow, but complete cure of both visceral leishmaniasis and its related skin dissemination, in absence of adverse events and long-term disease relapses.
Manfredi
R
R
Division of Infectious Diseases, Department of Internal Medicine, Aging and Nephrologic Diseases, S. Orsola-Malpighi Hospital, Bologna, Italy. Roberto.manfredi@unibo.it
Passarini
B
B
D'Antuono
A
A
Misciali
C
C
Marinacci
G
G
Calza
L
L
D000328:Adult; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D016774:Leishmaniasis, Diffuse Cutaneous / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D007898:Leishmaniasis, Visceral / Q000188:drug therapy / Q000209:etiology*; D008297:Male