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2013, Number 2

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Rev Med Inst Mex Seguro Soc 2013; 51 (2)

Visceral leishmaniasis in an HIV positive patient

Rossiere-Echazarreta NL, Rodríguez-Campos EA, Morales-Esponda M, Domínguez-Moreno R, Cruz-Ortiz M, Rodríguez-Guzmán LM

Language: Spanish
References: 26
Page: 222-227
PDF size: 105.46 Kb.


ABSTRACT

Background: visceral leishmaniasis is the most serious clinical picture of leishmaniasis or kala azar. In Mexico it is a rare disease, reason why it is diagnosed late concluding with patient´s death most of the times. We present a clinical case of an HIV positive male patient who developed visceral leishmaniasis, with the objective of showing the pathophysiological characteristics as well as the diagnostic approach and its treatment.
Clinical case: a 45-year-old male, worker of a water utility company presented to the hospital for having chronic bloody diarrhea, abdominal distension, cramping pain, weight loss and fever. On physical examination, he was febrile, with pain localized to the right lower quadrant and hepatosplenomegaly. The ELISA test for HIV was positive and the ultrasound showed a cecal tumor. A tumor biopsy was performed and the pathology report described leishmaniasis.
Conclusions: in patients with leishmaniasis and HIV the response to treatment is poor and the mortality rate is high due to lower immune response from the host. Current studies suggest treating these patients with HIV and leishmaniasis with pertinent drugs in combination with miltefosine and liposomal amphotericin B.


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