Case Report: Coinfection by Leishmania amazonensis and HIV in a Brazilian Diffuse Cutaneous Leishmaniasis Patient
| Autor: | Gustavo Henrique Corrêa Soares, Lucas Salomão de Sousa Ferreira, Andrea Beatrice Santos da Silva, Conceição de Maria Pedrozo e Silva de Azevedo, Mayara Ingrid Sousa Lima, Silma Regina Ferreira Pereira, Jorim Severino Ithamar, Guilherme de Alencar Medeiros |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty 030231 tropical medicine Antiprotozoal Agents Leishmaniasis Diffuse Cutaneous HIV Infections Gastroenterology Virus Lesion 03 medical and health sciences 0302 clinical medicine Virology Internal medicine Amphotericin B medicine Humans Amastigote Pentamidine Leishmania Meglumine Antimoniate biology business.industry Coinfection Leishmaniasis Articles Middle Aged medicine.disease biology.organism_classification Infectious Diseases Treatment Outcome Etiology Parasitology medicine.symptom business medicine.drug |
| Zdroj: | Am J Trop Med Hyg |
| Popis: | Diffuse cutaneous leishmaniasis (DCL) is a rare type of leishmaniasis characterized by diffuse skin lesions. In Brazil, Leishmania (L.) amazonensis is the main etiological agent of this clinical form. The state of Maranhão has the highest prevalence of this disease in the country, as well as a high rate of HIV infection. Here, we report the first case of DCL/HIV of Brazil. A 46-year-old man from the Amazonian area of Maranhão state presented atypical lesion in the left upper limb and dissemination of diffuse erythematous nodules over his entire body. Histopathological examination confirmed the presence of intracellular amastigotes of Leishmania, and a polymerase chain reaction and molecular identification by restriction fragment profile identified L. (L.) amazonensis as the causative agent of the disease. The patient was also diagnosed with HIV virus after the leishmaniasis diagnosis. The initial treatments for leishmaniasis were liposomal amphotericin B (AmB-L) (4 mg/kg) for 10 days and prophylactic use of Glucantime(®) (10 mg/Sb(+5)/kg) for 2 months. After unsuccessful initial treatments, he was treated with a combination of AmB-L (4 mg/kg) alternated with pentamidine (4 mg/kg) for 10 days but failed in the first therapeutic cycle. Subsequently, he had a good response to treatment with pentamidine (4 mg/kg). |
| Databáze: | OpenAIRE |
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