-
Views
-
Cite
Cite
P. Blanche, B. Gombert, O. Rivoal, S. Abad, D. Salmon, A. Brezin, Uveitis Due to Leishmania major as Part of HAART-Induced Immune Restitution Syndrome in a Patient with AIDS, Clinical Infectious Diseases, Volume 34, Issue 9, 1 May 2002, Pages 1279–1280, https://doi.org/10.1086/338720
Close - Share Icon Share
Extract
Although it is not an AIDS-defining illness, visceral leishmaniasis (VL) is a severe opportunistic infection in HIV-infected patients. VL is common in southern Europe [1]. Most reported cases of HIV-VL coinfection involve Leishmania infantum and generally occur when the patient's CD4 cell count is µ200 cells/mm3. Leishmania amastigotes are found in atypical locations (mostly in the gastrointestinal and respiratory tracts) in severely immunocompromised patients [2]. Cutaneous lesions in patients with VL are being reported with increasing frequency; however, exclusively cutaneous leishmaniasis has remained rare in patients with HIV infection [3].
We describe a patient with AIDS and diffuse cutaneous and ganglionary leishmaniasis, without visceral involvement, due to Leishmania major. The patient developed isolated severe uveitis due to leishmaniasis while receiving highly active antiretroviral therapy (HAART), which led to the loss the right eye, despite the administration of antiparasital therapy.
In September 1997, an HIV-infected, 34-year-old man from Burkina Faso (CD4 cell count, 4 cells/mm3; plasma virus load, 381,000 RNA copies/mL) had diffuse cutaneous and ganglionary leishmaniasis diagnosed by means of culture of several cutaneous and ganglionar biopsy smears. The results of cultures of blood, bone marrow, and gastrointestinal tract samples were negative. PCR amplification of a repetitive noncoding sequence and additional molecular typing by sequence analysis contributed to the diagnosis of Leishmania major zymodene MON-26 infection—the second case reported in a patient from Burkina Faso and the second case reported in association with HIV infection [4].
