Infection

, Volume 26, Issue 2, pp 93–99 | Cite as

Mediterranean leishmaniasis in HIV-infected patients: Epidemiological, clinical, and diagnostic features of 22 cases

  • C. Agostoni
  • N. Dorigoni
  • A. Malfitano
  • L. Caggese
  • G. Marchetti
  • S. Corona
  • S. Gatti
  • M. Scaglia
Clinical and Epidemiological Studies Originalia

Summary

Twenty-two Italian HIV-infected patients developed leishmaniasis, clinically manifested as visceral (13 cases), cutaneous (2 cases) and disseminated disease (7 cases). Twenty were males and two females (mean age: 32.8 years) with a mean CD4+ cell count of 46.8/μl at diagnosis; risk factors were intravenous drug use (17 patients) and sexual behaviour (two bisexual, two homosexual, one heterosexual). All but one patient lived or travelled in hypoendemic Italian regions and other Mediterranean countries. Apart from the two patients with cutaneous leishmaniasis, the clinico-pathological and biological spectrum of the infection was often atypical, especially in patients with disseminated disease. The diagnosis was routinely made by direct recovery of parasites in biological specimens, mainly in bone marrow aspirate, whereas serology was negative or borderline in most of the patients. Among 17in vitro isolates,Leishmania infantum was the only species involved with previously undescribed isoenzyme patterns in two cases. Treatment with antimonials and other drugs showed only temporary clinical improvement in some patients. Relapses were the rule. Leishmaniasis confirms itself as an opportunistic infection in HIV-positive persons. Secondary chemoprophylaxis should be considered in cases of relapsing disease.

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Copyright information

© MMV Medizin Verlag GmbH Mönchen 1998

Authors and Affiliations

  • C. Agostoni
    • 1
  • N. Dorigoni
    • 3
  • A. Malfitano
    • 2
  • L. Caggese
    • 4
  • G. Marchetti
    • 5
  • S. Corona
    • 1
  • S. Gatti
    • 1
  • M. Scaglia
    • 6
  1. 1.Parasitology Lab, Virology ServiceIRCCS PoliclinicoPavia
  2. 2.Div. of Infectious and Tropical DiseasesIRCCS PoliclinicoPavia
  3. 3.Div. of Infectious DiseasesTrento HospitalTrento
  4. 4.Div. of Infectious DiseasesCa Granda HospitalMilano
  5. 5.Div. of Infectious DiseasesGeneral HospitalBusto ArsizioItaly
  6. 6.Infectious Diseases Research Labs (Parasitology Lab)University-IRCCS San Matteo, viale Taramelli 5PaviaItaly

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