Leishmania mexicana may cause visceral involvement: First case described in an AIDS patient

NOCITO, ISABEL; ESTEBAN SERRA; MONTERO, ANTONIO

THE AMERICAN JOURNAL OF MEDICINE.

ELSEVIER SCIENCE INC

Año: 2002 vol. 113 p. 260 - 262

0002-9343

Sandflies (Phlebotomus perniciosus)are the classic carriers of leishmaniasis,and rodents and caninespecies are most commonly affected(4). However, the spread of HIV infectionhas changed the epidemiologyof leishmaniasis, and coinfection ofHIV and Leishmania is more prevalent,with parenteral transmission viaintravenous drug use often being themain route of infection (5?7).More than 20 Leishmania specieshave been identified. Although datafrom Africa and South America arescarce, the onset of visceral leishmaniasis,even in HIV-infected patients,remains strictly associated with Leishmaniaspecies that are classically associatedwith visceral involvement(8,9), such as L. infantum, which isfound in the Mediterranean, L. donovaniin Asia and Africa, and L. chagasiin South America (3).Clinicians should be aware of theeffects of AIDS on the epidemiologyof leishmaniasis. In our patient, L.mexicana infection, which is usuallyassociated with diffuse cutaneousleishmaniasis, led to a disseminatedand fatal visceral disease. This casealso shows the usefulness of SL RNAgene amplification?based PCR in detectingand classifying Leishmania organismsin paraffined biopsy specimens(10).