2011, Number 2
Rev Med MD 2011; 2.3 (2)
Visceral Leishmaniasis and Mycobacterium tuberculosis in a patient with AIDS in Mexico
Manríquez-Reyes M, Chable-Montero F, Gamboa-Domínguez A, Estradas-Trujillo JA, Chávez-Mazari B, Ingerborg B, Pérez-Patrigeon S, Ponce De León-Garduño A
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21-years-old man with untreated HIV infection diagnosed 5 years ago and a history of chronic diarrhea and fever. After the
initiation of antiretroviral therapy, he presented acute abdomen. Therefore, a laparotomy was performed and in the
anatopathologic examination of resected bowel was observed acid-fast bacilli and intracellular infectious structures of
. He was treated with Amphotericin B, desoxicolate and anti-tuberculosis treatment.
Visceral Leishmaniasis is transmitted by the bite of several sandflies of the genera Phlebotomus and Lutzomyia
. It is commonly
characterized by fever, chills, vomiting, anemia, hepatosplenomegaly, leukopenia, hypergammaglobulinemia, emaciation, and
an earth-gray color of the skin. HIV pandemic has changed the natural history of Leishmaniasis, increasing the risk of visceral
Leishmaniasis, with an incidence of 1/100-1000 patients in endemic areas. In HIV patients, Leishmania
accelerates the AIDS
onset, because of the immunosuppression and the stimulation for the virus replication. According to the World Health
Organization (WHO), not a case of Visceral Leishmaniasis coinfection and HIV has been reported in Mexico.
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