Nunnari A, Russo R, Cosentino S, Gradoni L, Gramiccia M, Bruno S, Zipper F, Tosto S, Nigro L, La Rosa R; International Conference on AIDS.

Int Conf AIDS. 1991 Jun 16-21; 7: 263 (abstract no. W.B.2327).

Institute of Infectious Diseases - University of Catania - Italy

Since July 1990 we observed three cases of visceral leishmaniasis in patients with acquired immunodeficiency syndrome, all residing in Eastern Sicily. The main clinical pattern was characterized by irregular fever for 1 to 6 months, weight loss, hepatosplenomegaly, pancytopenia and, in 2 of 3 patients, hypergammaglobulinemia. The diagnosis was supported by finding Leishmania amastigotes from bone marrow aspirate (2 of 3 patients) and by a positive serology (immunofluorescence) with 1/100 up to 1/1600 antibody titres. Bone marrow culture allowed to isolate a dermotropic zymodeme of L. infantum (MON 78, agent of cutaneous leishmaniasis in the Maltese islands) and a new L. infantum zymodeme (MON code to be assigned); the third case is in course of characterization. Therapy was performed with meglumine antimoniate or sodium antimony gluconate combined with allopurinol. DISCUSSION AND CONCLUSIONS: A delay or an obstacle to the clinical diagnosis of visceral leishmaniasis is represented by the presence of clinical signs, which may be ascribed to HIV infection or to drugs' toxicity; furthermore our cases raise the possibility of a visceral dissemination of dermotropic strains of L. infantum; this datum confirm the hypothesis, already suggested by other Authors, that in endemic areas visceral leishmaniasis may be considered as an opportunistic infection due to endogenous reactivation.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Antimony
• HIV Infections
• Humans
• Leishmania
• Leishmania donovani
• Leishmania infantum
• Leishmania major
• Leishmaniasis, Cutaneous
• Leishmaniasis, Visceral
• Meglumine
• Opportunistic Infections
• Organometallic Compounds
• Serologic Tests
• Sicily
• epidemiology
• meglumine antimoniate

Other ID:

• 3232791

UI: 102192958

From Meeting Abstracts