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An unusual presentation of leishmaniasis in a human immunodeficiency virus-positive individual
INTRODUCTION: Leishmaniasis is a neglected tropical disease caused by vector-borne protozoa of the genus Leishmania. Cutaneous and mucocutaneous forms result in disfiguration or mutilation, whilst visceral leishmaniasis (VL) affects multiple organs and is fatal if untreated. Notably, Leishmania are...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Microbiology Society
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5343128/ https://www.ncbi.nlm.nih.gov/pubmed/28348746 http://dx.doi.org/10.1099/jmmcr.0.005011 |
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author | Roiko, Marijo S. Schmitt, Bryan H. Relich, Ryan F. Meyer, Thomas L. Zhang, Shanxiang Davis, Thomas E. |
author_facet | Roiko, Marijo S. Schmitt, Bryan H. Relich, Ryan F. Meyer, Thomas L. Zhang, Shanxiang Davis, Thomas E. |
author_sort | Roiko, Marijo S. |
collection | PubMed |
description | INTRODUCTION: Leishmaniasis is a neglected tropical disease caused by vector-borne protozoa of the genus Leishmania. Cutaneous and mucocutaneous forms result in disfiguration or mutilation, whilst visceral leishmaniasis (VL) affects multiple organs and is fatal if untreated. Notably, Leishmania are capable of establishing a chronic infection, which may reactivate years after initial infection when the host becomes immune-suppressed. CASE PRESENTATION: A 24-year-old human immunodeficiency virus (HIV)-positive male presented for excision of anal condylomas. At the time of his current condyloma excision, the patient had no additional symptoms or cutaneous findings, but was noted to have been only intermittently compliant with his antiretroviral therapy. Microscopic examination of the haematoxylin and eosin-stained anal condyloma tissue revealed koilocytic change, ulceration and brisk histiocytic inflammation containing numerous small intracellular bodies suggestive of Leishmania amastigotes. A bone marrow biopsy was performed and demonstrated similar intracellular forms. Anal condyloma tissue and bone marrow aspirate were sent to the Centers for Disease Control and Prevention's Parasitic Diseases Branch for confirmation of Leishmania and speciation. Specific immunohistochemical staining for Leishmania in the tissue section was positive and the species was confirmed as Leishmania donovani by PCR. Subsequently, the patient resumed highly active antiretroviral therapy and received anti-Leishmania therapy. CONCLUSION: Whilst the presentation of VL in HIV-positive patients is often similar to those without HIV, here we describe an unusual initial presentation of leishmaniasis in an HIV-positive patient where the parasite was found in an anal condyloma. VL is a critical diagnosis that should be considered and pursued when leishmaniasis is encountered in seemingly illogical clinical settings. |
format | Online Article Text |
id | pubmed-5343128 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Microbiology Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-53431282017-03-27 An unusual presentation of leishmaniasis in a human immunodeficiency virus-positive individual Roiko, Marijo S. Schmitt, Bryan H. Relich, Ryan F. Meyer, Thomas L. Zhang, Shanxiang Davis, Thomas E. JMM Case Rep Case Report INTRODUCTION: Leishmaniasis is a neglected tropical disease caused by vector-borne protozoa of the genus Leishmania. Cutaneous and mucocutaneous forms result in disfiguration or mutilation, whilst visceral leishmaniasis (VL) affects multiple organs and is fatal if untreated. Notably, Leishmania are capable of establishing a chronic infection, which may reactivate years after initial infection when the host becomes immune-suppressed. CASE PRESENTATION: A 24-year-old human immunodeficiency virus (HIV)-positive male presented for excision of anal condylomas. At the time of his current condyloma excision, the patient had no additional symptoms or cutaneous findings, but was noted to have been only intermittently compliant with his antiretroviral therapy. Microscopic examination of the haematoxylin and eosin-stained anal condyloma tissue revealed koilocytic change, ulceration and brisk histiocytic inflammation containing numerous small intracellular bodies suggestive of Leishmania amastigotes. A bone marrow biopsy was performed and demonstrated similar intracellular forms. Anal condyloma tissue and bone marrow aspirate were sent to the Centers for Disease Control and Prevention's Parasitic Diseases Branch for confirmation of Leishmania and speciation. Specific immunohistochemical staining for Leishmania in the tissue section was positive and the species was confirmed as Leishmania donovani by PCR. Subsequently, the patient resumed highly active antiretroviral therapy and received anti-Leishmania therapy. CONCLUSION: Whilst the presentation of VL in HIV-positive patients is often similar to those without HIV, here we describe an unusual initial presentation of leishmaniasis in an HIV-positive patient where the parasite was found in an anal condyloma. VL is a critical diagnosis that should be considered and pursued when leishmaniasis is encountered in seemingly illogical clinical settings. Microbiology Society 2016-02-05 /pmc/articles/PMC5343128/ /pubmed/28348746 http://dx.doi.org/10.1099/jmmcr.0.005011 Text en © 2015 The Authors http://creativecommons.org/licenses/by/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/). |
spellingShingle | Case Report Roiko, Marijo S. Schmitt, Bryan H. Relich, Ryan F. Meyer, Thomas L. Zhang, Shanxiang Davis, Thomas E. An unusual presentation of leishmaniasis in a human immunodeficiency virus-positive individual |
title | An unusual presentation of leishmaniasis in a human immunodeficiency virus-positive individual |
title_full | An unusual presentation of leishmaniasis in a human immunodeficiency virus-positive individual |
title_fullStr | An unusual presentation of leishmaniasis in a human immunodeficiency virus-positive individual |
title_full_unstemmed | An unusual presentation of leishmaniasis in a human immunodeficiency virus-positive individual |
title_short | An unusual presentation of leishmaniasis in a human immunodeficiency virus-positive individual |
title_sort | unusual presentation of leishmaniasis in a human immunodeficiency virus-positive individual |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5343128/ https://www.ncbi.nlm.nih.gov/pubmed/28348746 http://dx.doi.org/10.1099/jmmcr.0.005011 |
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