Visceral leishmaniasis with HIV co-infection and cervical lymphadenopathy

Visceral leishmaniasis (VL) is prevalent worldwide. In the past there has been steep rise in the incidence of VL in southern Europe and Africa. Factors attributed for this are economic development, a shift of the reservoir of Leishmania, immunodeficiency due to HIV infection and intravenous drug abuse. The co-infection of VL and HIV is common in southern European-African countries and is proposed that it should be included as an AIDS-defining illness. VL is not only considered to be an opportunistic infection in HIV-infected individuals but it may also reactivate latent infection. This case is worth reporting as it highlights increasing incidence of VL-HIV co-infection and its sparse literature from India, changing ecology and possible evolving epidemic in the Indian subcontinent. Additionally an atypical presentation such as lymphadenopathy in VL should arouse suspicion of HIV co-infection and vice versa.