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Acquired immunodeficiency syndrome-related visceral leishmaniasis presenting in a pleural effusion
C E Chenoweth1, S Singal, R D Pearson
1Department of Internal Medicine, University of Michigan, Ann Arbor.
Insights
Visceral leishmaniasis is a growing concern in immunocompromised individuals, particularly those with AIDS. This case highlights the importance of considering visceral leishmaniasis in AIDS patients presenting with pulmonary issues and a travel history.
Area of Science:
- Medical Parasitology
- Infectious Diseases
- Immunocompromised Host Research
Background:
- Visceral leishmaniasis (VL) is a parasitic disease endemic in many tropical and subtropical regions.
- VL is increasingly diagnosed in immunocompromised patients, notably those with Acquired Immunodeficiency Syndrome (AIDS).
- Pulmonary manifestations of VL are uncommon but can occur, especially in immunocompromised individuals.
Observation:
- A case of visceral leishmaniasis is presented in a patient diagnosed with AIDS.
- The patient exhibited unusual pulmonary symptoms, including bilateral pleural effusions.
- Diagnostic evaluation involved histologic examination of pleural fluid and bone marrow.
Findings:
- Histiocytes containing intracellular Leishmania amastigotes were identified in both pleural fluid and bone marrow samples.
- The findings confirmed disseminated visceral leishmaniasis in the context of advanced immunodeficiency.
- The parasitic load and tissue distribution were consistent with disseminated visceral leishmaniasis.
Implications:
- Visceral leishmaniasis should be included in the differential diagnosis for AIDS patients presenting with unexplained pulmonary symptoms.
- A relevant travel history to endemic areas is a crucial factor in suspecting VL in this patient population.
- Early recognition and diagnosis of visceral leishmaniasis in AIDS patients are vital for timely and effective treatment, potentially improving patient outcomes.
Abstract:
Visceral leishmaniasis is increasingly reported in immunocompromised patients, including patients with AIDS. We report a case of visceral leishmaniasis in an AIDS patient who presented with pulmonary symptoms and bilateral pleural effusions. Histologic evaluation of pleural fluid and bone marrow revealed histiocytes with intracellular Leishmania amastigotes. Visceral leishmaniasis should be considered in AIDS patients with a significant travel history who present with unexplained pulmonary symptoms.