Clinical Challenges in the Management of LeishmaniaHIV Coinfection in a Nonendemic Area : A Case Report

Abstract EN

We report on a 37-year-old male HIV-positive patient with generalized cutaneous leishmaniasis undiagnosed for several years.

Upon presentation, visceral leishmaniasis was diagnosed in addition to cutaneous manifestation of the disease.

Over a period of three years, several different treatment regimens including liposomal amphotericin B, liposomal amphotericin B with miltefosine, liposomal amphotericin B with interferon, and pentamidine combined fluconazole and allopurinol were applied until Leishmania PCR from blood turned negative.

This case supports the necessity of multidrug combinational and sequential therapy over a very prolonged period of time in severely immunosuppressed patients infected with Leishmania and highlights the tremendous individual but also economic burden of this disease.