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Diffuse skin spread of HIV-associated visceral leishmaniasis: cumbersome diagnostic and therapeutic issues
R Manfredi1, B Passarini, A D'Antuono
1Division of Infectious Diseases, Department of Internal Medicine, Aging and Nephrologic Diseases, S. Orsola-Malpighi Hospital, Bologna, Italy. Roberto.manfredi@unibo.it
Abstract:
An infrequent and atypical case report of HIV-associated visceral leishmaniasis complicated by a diffuse, aspecific maculo-papular cutaneous involvement was characterized by a prolonged course, and a lack of response to repeated attack/maintenance cycles performed with liposomal amphotericin B, despite a satisfactory immune response maintained thanks to a concurrent, potent combination antiretroviral treatment. Only a very prolonged administration of the older i.v. pentamidine isethionate together with oral paromomycin led to a slow, but complete cure of both visceral leishmaniasis and its related skin dissemination, in absence of adverse events and long-term disease relapses.
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