Author/Authors :
Molaei, M Department of Pathology - Research Center of Gastroenterology and Liver Disease - Shaheed Beheshti University of Medical Sciences, Tehran , Pejhan, Sh Department of Pathology - Research Center of Gastroenterology and Liver Disease - Shaheed Beheshti University of Medical Sciences, Tehran , Mashayekhi, R Department of Pathology - Research Center of Gastroenterology and Liver Disease - Shaheed Beheshti University of Medical Sciences, Tehran , Modaress Fatthi, AR Department of Pathology - Research Center of Gastroenterology and Liver Disease - Shaheed Beheshti University of Medical Sciences, Tehran , Minakari, M Departments of Gastroenterology and Hepatology - Isfahan University of Medical Sciences, Isfahan , Zali, MR Department of Gastroenterology - Research Center of Gastroenterology and Liver Disease - Shaheed Beheshti University of Medical Sciences, Tehran, Iran
Abstract :
In endemic regions, visceral leishmaniasis is one of the most common opportunistic infections in HIV positive
patients. Simultaneous infection with Leishmania and HIV has been reported in some countries but this is the first
report of such a case in Iran. Our patient was a 27 years old man with intermittent night fever, abdominal pain,
loss of appetite, vomiting, watery diarrhea and severe weight loss for 6 months. He had low socio-economic
status with an imprisonment history. The patient was quite cachectic and had low grade fever. Physical exam
and upper GI endoscopy revealed oropharyngeal candidiasis. Microscopic evaluation of duodenal biopsy material
showed Leishmania amastigotes in macrophages of lamina propria. Leishman bodies were also observed in
bone marrow aspiration specimen. Serologic tests were positive for Leishmania infantum. HIV antibody was also
positive with a CD4+cell count of 80/μl. The diagnosis was acquired immunodeficiency syndrome with simultaneous
visceral leishmaniasis involving intestinal mucosa.
