Connect
MJA
MJA

Visceral leishmaniasis due to Leishmania donovani in a patient with advanced HIV infection

Samuel C Hume, Craig A Aboltins, Karin A Thursky, John R Daffy and Peter A Stanley
Med J Aust 2010; 192 (8): . || doi: 10.5694/j.1326-5377.2010.tb03591.x
Published online: 19 April 2010

An Eritrean-born man observed over an extended period had upper gastrointestinal symptoms, fever, hepatosplenomegaly and pancytopenia in the setting of advanced HIV infection and poor adherence to antiretroviral therapy. Despite thorough investigation, it was not until a repeat gastroscopic examination and gastric biopsy were performed 18 months after initial presentation that Leishmania infection was diagnosed. The species was identified by polymerase chain reaction assay as L. donovani. Physicians managing HIV-infected patients from regions where Leishmania is endemic should consider visceral leishmaniasis, even in patients who have not lived in a Leishmania-endemic region for many years.

A 42-year-old Eritrean-born man who had previously lived in Sudan arrived in Australia in 1995. He had not travelled overseas since that time. He was diagnosed with HIV infection in 1996. He presented in 2005 with a 2-month history of odynophagia, dysphagia and vomiting.


  • 1 Department of Infectious Diseases, The Northern Hospital, Melbourne, VIC.
  • 2 St Vincent's Hospital, Melbourne, VIC.


Correspondence: sam.hume@mh.org.au

Competing interests:

None identified.

  • 1. Visvanathan K, Jones PD, Riordan SM, et al. Delayed reactivation of visceral leishmaniasis complicating HIV infection. Aust N Z J Med 1993; 23: 407.
  • 2. Alvar J, Aparicio P, Aseffa A, et al. The relationship between leishmaniasis and AIDS: the second 10 years. Clin Microbiol Rev 2008; 21: 334-359.
  • 3. ter Horst R, Collin SM, Ritmeijer K, et al. Concordant HIV infection and visceral leishmaniasis in Ethiopia: the influence of antiretroviral treatment and other factors on outcome. Clin Infect Dis 2008; 46: 1702-1709.
  • 4. Lyons S, Veeken H, Long J. Visceral leishmaniasis and HIV in Tigray, Ethiopia. Trop Med Int Health 2003; 8: 733-739.
  • 5. Desjeux P, Alvar J. Leishmania/HIV co-infections: epidemiology in Europe. Ann Trop Med Parasitol 2003; 97 Suppl 1: 3-15.
  • 6. Russo R, Laguna F, Lopez-Velez R, et al. Visceral leishmaniasis in those infected with HIV: clinical aspects and other opportunistic infections. Ann Trop Med Parasitol 2003; 97 Suppl 1: 99-105.
  • 7. Sinha PK, Rabidas VN, Pandey K, et al. Visceral leishmaniasis and HIV coinfection in Bihar, India. J Acquir Immune Defic Syndr 2003; 32: 115-116.
  • 8. Pintado V, Martin-Rabadan P, Rivera ML, et al. Visceral leishmaniasis in human immunodeficiency virus (HIV)-infected and non-HIV-infected patients. A comparative study. Medicine (Baltimore) 2001; 80: 54-73.
  • 9. Bern C, Adler-Moore J, Berenguer J, et al. Liposomal amphotericin B for the treatment of visceral leishmaniasis. Clin Infect Dis 2006; 43: 917-924.
  • 10. Ritmeijer K, Dejenie A, Assefa Y, et al. A comparison of miltefosine and sodium stibogluconate for treatment of visceral leishmaniasis in an Ethiopian population with high prevalence of HIV infection. Clin Infect Dis 2006; 43: 357-364.

Author

remove_circle_outline Delete Author
add_circle_outline Add Author

Comment
Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.