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Multiple cutaneous nodules in an HIV-infected patient.

Phumee A, Chusri S, Kraivichian K, Wititsuwannakul J, Hortiwakul T, Thavara U, Silpapojakul K, Siriyasatien P - PLoS Negl Trop Dis (2014)

View Article: PubMed Central - PubMed

Affiliation: Medical Science Program, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

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He was diagnosed with disseminated cutaneous and visceral leishmaniasis 2 years previously and was treated with amphotericin B deoxycholate and itraconazole for leishmaniasis and with tenofovir, lamivudine, and nevirapine for HIV... Diagnosis of relapsed Leishmania siamensis infection in this patient was performed by microscopic examination, culture, and polymerase chain reaction (PCR)... Microscopic examination of tissue sections from his brow showed numerous intracellular organisms (Fig. 2A), and typical Leishmania amastigote parasites containing nucleus and kinetoplast were shown in a tissue biopsy that was submerged in Schneider's medium for two days and its sections then cut and stained with hematoxylin and eosin (H&E) (Fig. 2B)... Numerous promastigotes were also observed in culture... After a final diagnosis of nodular leishmaniasis was established, the patient received 1 mg/kg/day of intravenous amphotericin B deoxylate for 28 days, followed by 300 mg of oral itraconazole twice a day for 5 months... Globally, leishmaniasis is a significant cause of morbidity and mortality in several countries... The disease is often a coinfection among HIV patients, tourists, refugees, and military personnel as well as among residents of endemic areas... Leishmaniasis is usually found in HIV patients who have a CD-4+T cell level less than 200 cells/mm–... Samples used for PCR for L. siamensis include blood, bone marrow, tissue, urine, and saliva... Recently, Phumee and colleagues demonstrated that saliva is a good source for PCR detection of L. siamensis DNA... They also demonstrated that L. siamensis DNA levels in saliva decreased after treatment... Recurrence of L. siamensis infection after amphotericin B therapy occurred in some patients... As documented in, a seronegative girl was successfully treated for a recurrent L. siamensis infection after amphotericin B treatment by extending amphotericin B therapy from 3 weeks to 5 weeks and following it with 6 months of prophylaxis.

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Related in: MedlinePlus

Nodules on brow, left second toe, left ring finger, and left elbow of nodular leishmaniasis case.
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pntd-0003291-g001: Nodules on brow, left second toe, left ring finger, and left elbow of nodular leishmaniasis case.

Mentions: The patient was a 49-year-old male rubber planter living in southern Thailand who has had HIV infection for 10 years. He was diagnosed with disseminated cutaneous and visceral leishmaniasis 2 years previously and was treated with amphotericin B deoxycholate and itraconazole for leishmaniasis and with tenofovir, lamivudine, and nevirapine for HIV. Six months before this visit, he observed multiple nodules on his brow, left second toe, left ring finger, and left elbow (Fig. 1). His CD4+ Tcell count was 207 cells/mm3.


Multiple cutaneous nodules in an HIV-infected patient.

Phumee A, Chusri S, Kraivichian K, Wititsuwannakul J, Hortiwakul T, Thavara U, Silpapojakul K, Siriyasatien P - PLoS Negl Trop Dis (2014)

Nodules on brow, left second toe, left ring finger, and left elbow of nodular leishmaniasis case.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4263422&req=5

pntd-0003291-g001: Nodules on brow, left second toe, left ring finger, and left elbow of nodular leishmaniasis case.
Mentions: The patient was a 49-year-old male rubber planter living in southern Thailand who has had HIV infection for 10 years. He was diagnosed with disseminated cutaneous and visceral leishmaniasis 2 years previously and was treated with amphotericin B deoxycholate and itraconazole for leishmaniasis and with tenofovir, lamivudine, and nevirapine for HIV. Six months before this visit, he observed multiple nodules on his brow, left second toe, left ring finger, and left elbow (Fig. 1). His CD4+ Tcell count was 207 cells/mm3.

View Article: PubMed Central - PubMed

Affiliation: Medical Science Program, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

He was diagnosed with disseminated cutaneous and visceral leishmaniasis 2 years previously and was treated with amphotericin B deoxycholate and itraconazole for leishmaniasis and with tenofovir, lamivudine, and nevirapine for HIV... Diagnosis of relapsed Leishmania siamensis infection in this patient was performed by microscopic examination, culture, and polymerase chain reaction (PCR)... Microscopic examination of tissue sections from his brow showed numerous intracellular organisms (Fig. 2A), and typical Leishmania amastigote parasites containing nucleus and kinetoplast were shown in a tissue biopsy that was submerged in Schneider's medium for two days and its sections then cut and stained with hematoxylin and eosin (H&E) (Fig. 2B)... Numerous promastigotes were also observed in culture... After a final diagnosis of nodular leishmaniasis was established, the patient received 1 mg/kg/day of intravenous amphotericin B deoxylate for 28 days, followed by 300 mg of oral itraconazole twice a day for 5 months... Globally, leishmaniasis is a significant cause of morbidity and mortality in several countries... The disease is often a coinfection among HIV patients, tourists, refugees, and military personnel as well as among residents of endemic areas... Leishmaniasis is usually found in HIV patients who have a CD-4+T cell level less than 200 cells/mm–... Samples used for PCR for L. siamensis include blood, bone marrow, tissue, urine, and saliva... Recently, Phumee and colleagues demonstrated that saliva is a good source for PCR detection of L. siamensis DNA... They also demonstrated that L. siamensis DNA levels in saliva decreased after treatment... Recurrence of L. siamensis infection after amphotericin B therapy occurred in some patients... As documented in, a seronegative girl was successfully treated for a recurrent L. siamensis infection after amphotericin B treatment by extending amphotericin B therapy from 3 weeks to 5 weeks and following it with 6 months of prophylaxis.

No MeSH data available.


Related in: MedlinePlus