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- Title
Development of visceral leishmaniasis in an HIV patient upon immune reconstitution following the initiation of antiretroviral therapy.
- Authors
Schleenvoigt, Benjamin; Ignatius, Ralf; Baier, Michael; Schneider, Thomas; Weber, Marko; Hagel, Stefan; Forstner, Christina; Pletz, Mathias
- Abstract
Case presentation: Here, we report on a case of VL in an HIV-infected patient from the Republic of Georgia who had moved to Germany 14 years before and who had travelled several times to southern Europe in between. After presenting with typical Pneumocystis jiroveci pneumonia, which was treated appropriately, the patient was started on antiretroviral therapy. Shortly thereafter, however, he developed fever of unknown origin. All laboratory assays for the diagnosis of various infectious agents including serological assays and polymerase chain reaction testing of bone marrow aspirate to diagnose VL did not yield positive results at first. Only upon repetition of these tests, diagnosis of VL could be made and the patient treated accordingly. Case discussion: Visceral leishmaniasis (VL) is a common opportunistic infection in HIV-positive patients from endemic countries but occurs rarely following antiretroviral treatment. This case demonstrates that patients who develop VL upon immune reconstitution may not be diagnosed initially by standard laboratory assays for the diagnosis of VL and underlines the necessity to repeat serologic and molecular biologic testing for VL in cases of fever of unknown origin in patients from or with travel history to endemic countries.
- Subjects
LEISHMANIASIS diagnosis; ANTIRETROVIRAL agents; AIDS-related opportunistic infections; BONE marrow examination; FEVER; HIV infections; LEISHMANIASIS; PNEUMOCYSTIS pneumonia; POLYMERASE chain reaction; IMMUNE reconstitution inflammatory syndrome; DIAGNOSIS
- Publication
Infection, 2016, Vol 44, Issue 1, p115
- ISSN
0300-8126
- Publication type
Article
- DOI
10.1007/s15010-015-0813-7