Open AccessClinical Challenges in the Management of Leishmania/HIV Coinfection in a Nonendemic Area: A Case Report
Author(s) -
Katharina GrabmeierPfistershammer,
Wolfgang Poeppl,
Patrick M. Brunner,
K. Rappersberger,
Armin Rieger
Publication year - 2012
Publication title -
case reports in infectious diseases
Language(s) - English
Resource type - Journals
eISSN - 2090-6625
pISSN - 2090-6633
DOI - 10.1155/2012/787305
Subject(s) - miltefosine , medicine , pentamidine , amphotericin b , leishmaniasis , visceral leishmaniasis , allopurinol , leishmania , fluconazole , cutaneous leishmaniasis , coinfection , tropical disease , dermatology , immunology , disease , human immunodeficiency virus (hiv) , antifungal , pneumonia , parasite hosting , world wide web , computer science
We report on a 37-year-old male HIV-positive patient with generalized cutaneous leishmaniasis undiagnosed for several years. Upon presentation, visceral leishmaniasis was diagnosed in addition to cutaneous manifestation of the disease. Over a period of three years, several different treatment regimens including liposomal amphotericin B, liposomal amphotericin B with miltefosine, liposomal amphotericin B with interferon, and pentamidine combined fluconazole and allopurinol were applied until Leishmania PCR from blood turned negative. This case supports the necessity of multidrug combinational and sequential therapy over a very prolonged period of time in severely immunosuppressed patients infected with Leishmania and highlights the tremendous individual but also economic burden of this disease.
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