Recurrence of visceral and muco-cutaneous leishmaniasis in a patient under immunosuppressive therapy View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-07-07

AUTHORS

Gilles Darcis, Gert Van der Auwera, Jean-Baptiste Giot, Marie-Pierre Hayette, Françoise Tassin, Jorge Arrese Estrada, Lieselotte Cnops, Michel Moutschen, Laurence de Leval, Philippe Leonard

ABSTRACT

BackgroundLeishmaniasis is a protozoan disease caused by parasites of the genus Leishmania, transmitted to humans by sandflies. The diagnosis of leishmaniasis is often challenging as it mimics many other infectious or malignant diseases. The disease can present in three ways: cutaneous, mucocutaneous, or visceral leishmaniasis, which rarely occur together or consecutively.Case presentationThe patient was a 52 years old immunosuppressed Belgian woman with a long history of severe rheumatoid arthritis. She underwent bone marrow biopsy to explore thrombocytopenia. Diagnosis of visceral leishmaniasis was made by identification of Leishman Donovan (LD) bodies in macrophages. Treatment with liposomal amphotericin B was successful. She later developed cutaneous leishmaniasis treated with amphotericin B lipid complex. She next presented with relapsing cutaneous lesions followed by rapidly progressing lymphadenopathies. Biopsy confirmed the diagnosis of leishmaniasis. Treatments by miltefosine, amphotericin B, N-methyl-glucamine antimoniate were subsequently initiated. She later presented a recurrent bone marrow involvement treated with intramuscular paromomycin and miltefosine. She died two years later from leukemia. At the time of death, she presented with a mucosal destruction of the nose. A Leishmania-specific PCR (Polymerase Chain Reaction) identified L. infantum as etiological agent.ConclusionsClinicians should be aware of the potential concomitant or sequential involvement of multiple anatomic localizations of Leishmania in immunosuppressed patients. More... »

PAGES

478

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http://scigraph.springernature.com/pub.10.1186/s12879-017-2571-x

DOI

http://dx.doi.org/10.1186/s12879-017-2571-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1090380785

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28687071


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