Roig-Marín N, Roig-Rico P, Mayol-Belda MJ, Seguí-Ripoll JM

Language: Spanish
References: 0
Page: 203-206
PDF size: 225.88 Kb.

ABSTRACT

Antecedentes: Leishmaniasis is found with a wide distribution around the world. An overall global prevalence of 12 million people affected is estimated. There are various endemic areas, such as the Mediterranean countries, specifically Spain. It is an opportunistic infection that is more common in people with the human immunodeficiency virus (HIV). Visceral leishmaniasis has a higher incidence than cutaneous leishmaniasis in HIV patients. Cutaneous leishmaniasis is an infrequent form.
Clinical case: A 32-year-old male, formerly addicted to intravenous drugs, diagnosed with HIV infection and chronic liver disease caused by the hepatitis C virus. He was hospitalized because of an exophytic lesion, exudative ulceration in the antero-lateral face of the left lower limb, seven months in evolution. After being physical examined, the patient was only found with hepatosplenomegaly. A biopsy of the skin lesion showed inflammatory infiltrate in the dermis with histiocytes and abundant leishmania in the cytoplasm. Bone marrow puncture was negative for Leishmania. The patient was treated with intramuscular meglumine antimoniate (Glucantime) at usual doses for five weeks. The patient responded well to treatment; no pathogens were detected in subsequent biopsies.
Conclusions: In such a country as Spain where Leishmania is endemic, the presence of an HIV patient with a long-lasting papulonodular lesion in exposed skin, which can ulcerate, should make us suspect leishmaniasis. Therefore, a diagnostic biopsy should be performed for confirmation.