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Memorias del Instituto de Investigaciones en Ciencias de la Salud

On-line version ISSN 1812-9528


CHENA, Lilian et al. Leishmania infantum, HIV and Hystoplasma capsulatum coinfection: dermatologic manifestations. Mem. Inst. Investig. Cienc. Salud [online]. 2016, vol.14, n.3, pp.121-125. ISSN 1812-9528.

Leishmania/HIV coinfection is frequent and generally they are visceral leishmaniasis cases (VL). However, Leishmania infantum, the etiological agent, could also cause cutaneous forms in HIV-positive patients. The parasites reach the skin through diffusion, a new infection or a reactivation of a latent infection. There are molecular techniques that confirm the diagnosis and characterize Leishmania species. These patients also present other opportunistic infections like histoplasmosis, well known as an AIDS marker and caused by Histoplasma capsulatum. In this work, we describe one HIV/histoplasmosis/VL coinfection case associated to cutaneous lesions. The patient was a male, adult, coming from the city of J.A. Saldívar, HIV positive (since 2010), without antiretroviral treatment. He was hospitalized in 2012 at the Instituto de Medicina Tropical (IMT) with fever, anemia, hepatosplenomegaly, bone marrow smear and rK39 both negative for Leishmania. He was treated with Amphotericin B. In 2013, he presented a prolonged febrile syndrome and Leishmania amastigotes were observed in the bone marrow. In 2014, the patient presented ulcerations on the face where H. capsulatum fungal spores and Leishmania amastigotes were observed. L. infantumwas confirmed by molecular methods. In the case under study we can conclude that the dermal manifestation was caused by L. infantum according to the characterization by molecular techniques, and simultaneously H. capsulatum was present due to his immunological status. It should be emphasized the importance of the differential diagnosis in order to apply the right treatment and also the uncommon clinical manifestation that is not associated to this Leishmania species.

Keywords : Leishmaniainfantum; Histoplasmacapsulatum; HIV; cutaneous lesions.

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