Dermonodular and Visceral Leishmaniasis Due to Leishmania infantum with a New Isoenzyme Pattern: Report of a Case Involving a Patient with AIDS

Herein we report a leishmania infection in a patient with AIDS, which was associated with atypical clinical findings and was caused by an L. infantum strain with a new isoenzyme pattern. A 36-year-old Italian man who was an iv drug user and had been seropositive for antibodies to HIV since 1986 was...

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Bibliographic Details
Published in:Clinical infectious diseases 1996-02, Vol.22 (2), p.376-377
Main Authors: Scaglia, Massimo, Malfitano, Antonello, Douville, Hélène, Sacchi, Paolo, Gatti, Simonetta, Gradoni, Luigi, Gramiccia, Marina
Format: Article
Language:English
Subjects:
Acquired Immunodeficiency Syndrome - complications
Adult
AIDS
AIDS/HIV
Animals
Biological and medical sciences
Bone marrow
Bone Marrow - parasitology
Brief Reports
Fever
HIV
Human protozoal diseases
Humans
Infections
Infectious diseases
Isoenzymes - analysis
Leishmania infantum
Leishmania infantum - enzymology
Leishmania infantum - isolation & purification
Leishmaniasis, Visceral - complications
Leishmaniasis, Visceral - parasitology
Leshmaniasis
Male
Medical sciences
Nodules
Parasitic diseases
Parasitology
Protozoal diseases
Skin - parasitology
Visceral leishmaniasis
Zymodemes
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Summary:Herein we report a leishmania infection in a patient with AIDS, which was associated with atypical clinical findings and was caused by an L. infantum strain with a new isoenzyme pattern. A 36-year-old Italian man who was an iv drug user and had been seropositive for antibodies to HIV since 1986 was first hospitalized in January 1992 for left hemiparesis. In April 1993 he complained again of persistent fever and arthromyalgias in addition to progressive weight loss. Leishmania amastigotes were seen in biopsy specimens of a nodule and in a bone marrow aspirate. Two 21-day courses of meglumine antimoniate at a dosage of 20 mg of antimony (Sb[v]) per kg per day did not clear the infection, although the fever disappeared. The patient requested to be discharged from the hospital. In November 1993 he was readmitted because of the reoccurrence of fever and arthromyalgias. Leishmania amastigotes were seen again in bone marrow and node biopsy specimens. An alternative therapy with two 21-day courses of aminosidine sulfate (12 mg/[kg-d] iv) plus sodium stibogluconate (20 mg Sb[v]/[kg-d]iv) was given. The subcutaneous nodules gradually disappeared, but parasites remained in the bone marrow. The patient died of wasting syndrome and persistent leishmaniasis in December 1993.
ISSN:1058-4838
1537-6591
DOI:10.1093/clinids/22.2.376