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Visceral leishmaniasis (VL), though widely prevalent in India, is not seen in the Rajasthan where the dry, hot and arid climatic conditions create a hostile environment for the growth of the parasite or its vector, the sandfly. We present a case of VL in a patient co-infected with HIV from this region. A 34-year-old known case of a HIV-positive pat...
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Introduction:
Visceral leishmaniasis is an endemic protozoan found in Brazil. It is characterized by fever, pallor, hepatosplenomegaly, lymphadenopathy, and progressive weakness in the patient. It may lead to death if untreated. The drug of choice for treatment is meglumine antimoniate (Glucantime). The aim of this study was to evaluate patients w...
A 36-year-old Nigerian man was assessed for chronic recurrent fever, generalized weakness, body aches, epistaxis and bleeding gums of 3-month duration. Despite receiving treatment for suspected malaria twice and undergoing multiple courses of antibiotics for suspected infections, his symptoms persisted. Examination revealed hepatosplenomegaly, lymp...
Background: Leishmaniasis is a parasitic disease caused by a Leishmania
species, transmitted to humans through bites of female sand fly and is
endemic in Iraq.
Aims: To study the epidemiological, clinical, diagnostic and therapeutic
aspects of visceral leishmaniasis in Iraqi children.
Patients and Methods: This was a retrospective study done on pat...
Citations
... 35 During these early years, several subclinical cases of leishmaniasis 21 started manifesting and various workers started publishing VL-HIV co-infection cases from Bihar and other parts of India. [47][48][49][50][51][52][53][54][55][56][57][58][59][60] Thakur et al. 47 reported the first case of HIV-VL co-infection from Bihar who was treated successfully with miltefosine. In 2002, Lanjewar and colleagues 48 reported a series of autopsy findings from 195 AIDS cases in Bombay. ...
... 52-54 A major study finding was that out of 55 VL-HIV cases treated with amphotericin B, 74.5% were cured, 14.5% relapsed, and 10.9% died within 2 years. Others are mostly case reports [55][56][57][58][59][60] (Table 1). Thus, a total of 89 published records of VL-HIV cases from India were identified to the date at which this manuscript was submitted. ...
... Vyas and Shah 58 reported probably the first case of visceral and concomitant PKDL in a patient from Rajasthan, an area endemic for CL only. The patient presented with non-tender papulo-nodular lesions all over the body and had hepatosplenomegaly and inguinal lymphadenopathy. ...
After HIV epidemic several countries reported co-infections of Leishmania with HIV. The co-infection of these two pathogens results into rapid disease progression, more severe disease and poor response to treatment. A systematic review of literature from India is presented here.
On reviewing the literature since first case of visceral leishmaniasis (VL) and HIV was published from India in 1999, a number of cases of HIV-leishmania co-infections have been reported, but the proportion has been low (0.029-0.4%) as reported to other countries where both these diseases are co-endemic. So far, more than 89 cases of VL-HIV and 10 cases of cutaneous leishmaniasis (CL) with HIV have been published since 1999. Of these 10 cases, 5 had simple CL and 5 cases manifested with diffuse cutaneous leishmaniasis (DCL). In addition, one case of post-kala-azar mucocutaneous leishmaniasis (PKML) in a full blown AIDS patient has also been reported. In two cases no clear description could be ascertained whether these were cases of DCL or post-kala-azar dermal leishmaniasis (PKDL). Though the first case of VL-HIV co-infection was reported from sub-Himalayan state of Uttarakhand, most cases are reported from VL endemic state of Bihar.
HIV-Leishmania is not alarmingly high in India. Most cases occurred during 1997-2007. After that the number of new cases has gone down. Most probably due to low HIV prevalence in VL and CL endemic regions and free supply of highly active anti-retroviral therapy (HAART) for HIV infected patients.
... Leishmania typically is vector-borne zoonosis, with rodents and canids as common resevior hosts and humans as incidental hosts. Current challenges include the emergence of leishmaniasis in the new geographic areas and host populations (especially in HIV-positive patients) (1)(2)(3)(4)(5)(6). Leishmania is common in Middle East including Iran. ...
... Leishmaniasis and tuberculosis both are caused by intracellular pathogens whose development depends on impaired cell-mediated immunity (18). This Co-infection previously detected in specific population such as in patients with primary immunodeficiency as well as secondary immunodeficiency (especially in HIV positive patients) (1,(3)(4)(5)(6)19). On the other hand, poverty, overcrowding, malnutrition, illiteracy, and poor domestic conditions facilitate the growth of these diseases (1). ...
Co-infection of tuberculosis and leishmaniasis has been reported previously in patients with altered immune response due to primary or secondary immunodeficiency. These intracellular pathogens have a unique interaction in the host immune response and their development depends on impaired cell-mediated immunity. A case of chronic non-healing cutaneous ulcer with chronic fistulating soft-tissue mass is presented here which co-infected with tuberculosis and leishmaniasis, interestingly in an otherwise healthy young female.
Keywords: Leishmaniasis, Cutaneous; Tuberculosis, Pulmonary; Bone
... Leishmania typically is vector-borne zoonosis, with rodents and canids as common resevior hosts and humans as incidental hosts. Current challenges include the emergence of leishmaniasis in the new geographic areas and host populations (especially in HIV-positive patients) (1)(2)(3)(4)(5)(6). Leishmania is common in Middle East including Iran. ...
... Leishmaniasis and tuberculosis both are caused by intracellular pathogens whose development depends on impaired cell-mediated immunity (18). This Co-infection previously detected in specific population such as in patients with primary immunodeficiency as well as secondary immunodeficiency (especially in HIV positive patients) (1,(3)(4)(5)(6)19). On the other hand, poverty, overcrowding, malnutrition, illiteracy, and poor domestic conditions facilitate the growth of these diseases (1). ...
In regions where it is endemic, visceral leishmaniasis is an important opportunistic infectious disease in people living with HIV. Typically, clinical presentation of visceral leishmaniasis includes chronic fever, hepatosplenomegaly, and weight loss. In Leishmania infantum endemic regions in Europe, atypical visceral leishmaniasis presentations have been well documented, with almost every possible organ involved. However, such reports are rare in Leishmania donovani endemic regions such as east Africa. In this Personal View, we describe the various atypical disease presentations in patients screened as part of an HIV and visceral leishmaniasis clinical trial in north Ethiopia, where up to 40% of patients with visceral leishmaniasis are co-infected with HIV. Atypical presentations such as these are not covered in clinical guidelines used in these settings. Apart from the lack of diagnostic facilities, this gap contributes to the underdiagnosis of atypical visceral leishmaniasis, with associated morbidity and mortality. Involvement of clinicians experienced with the management of HIV and visceral leishmaniasis co-infection in the development of HIV clinical guidelines in affected regions is warranted.
