Visceral leishmaniasis due to Leishmania donovani in a patient with advanced HIV infection.
An Eritrean-born man observed over an extended period had upper gastrointestinal symptoms, fever, hepatosplenomegaly and pancytopenia in the setting of advanced HIV infection and poor adherence to antiretroviral therapy. Despite thorough investigation, it was not until a repeat gastroscopic examination and gastric biopsy were performed 18 months after initial presentation that Leishmania infection was diagnosed. The species was identified by polymerase chain reaction assay as L. donovani. Physicians managing HIV-infected patients from regions where Leishmania is endemic should consider visceral leishmaniasis, even in patients who have not lived in a Leishmania-endemic region for many years.
Hume
Samuel C
SC
Department of Infectious Diseases, The Northern Hospital, Melbourne, VIC, Australia. sam.hume@mh.org.au
Aboltins
Craig A
CA
Thursky
Karin A
KA
Daffy
John R
JR
Stanley
Peter A
PA
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D006801:Humans; D018314:Leishmania infantum / Q000302:isolation & purification*; D007898:Leishmaniasis, Visceral / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D010349:Patient Compliance
D044966:Anti-Retroviral Agents; D000981:Antiprotozoal Agents