Relapse of Visceral Leishmaniasis in an HIV-Infected Patient Successfully Treated with a Combination of Miltefosine and Amphotericin B
The present report documents a 49-year-old HIV-infected man receiving antiretroviral therapy with a suboptimal immune response and a CD4 count of 95 cells/mm3, despite virological suppression. Investigation of bone marrow was conducted and yielded a diagnosis of visceral leishmaniasis. The clinical...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Canadian Journal of Infectious Diseases and Medical Microbiology |
| Online Access: | http://dx.doi.org/10.1155/2015/176545 |
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| author | Shauna McQuarrie Ken Kasper Dana C Moffatt Daniel Marko Yoav Keynan |
| author_facet | Shauna McQuarrie Ken Kasper Dana C Moffatt Daniel Marko Yoav Keynan |
| author_sort | Shauna McQuarrie |
| collection | DOAJ |
| description | The present report documents a 49-year-old HIV-infected man receiving antiretroviral therapy with a suboptimal immune response and a CD4 count of 95 cells/mm3, despite virological suppression. Investigation of bone marrow was conducted and yielded a diagnosis of visceral leishmaniasis. The clinical course was complicated by gastrointestinal involvment and relapse occurred after amphotericin B therapy. With the addition of miltefosine, the patient no longer presented with bone marrow amastigotes, and displayed an increased CD4 count and negative Leishmania polymerase chain reaction results. The present case highlights atypical presentation of visceral leishmaniasis, including poor immune reconstitution and gastrointestinal involvement. The high likelihood of relapse and response to combination therapy are illustrated. |
| format | Article |
| id | doaj-art-9aa9b89bc8a2450ca235777fe90e854c |
| institution | Kabale University |
| issn | 1712-9532 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Infectious Diseases and Medical Microbiology |
| spelling | doaj-art-9aa9b89bc8a2450ca235777fe90e854c2025-02-03T01:06:21ZengWileyCanadian Journal of Infectious Diseases and Medical Microbiology1712-95322015-01-0126632532910.1155/2015/176545Relapse of Visceral Leishmaniasis in an HIV-Infected Patient Successfully Treated with a Combination of Miltefosine and Amphotericin BShauna McQuarrie0Ken Kasper1Dana C Moffatt2Daniel Marko3Yoav Keynan4Manitoba HIV Program, University of Manitoba, CanadaManitoba HIV Program, University of Manitoba, CanadaDepartment of Internal Medicine, University of Manitoba, CanadaDiagnostic Services of Manitoba, Winnipeg, Manitoba, CanadaManitoba HIV Program, University of Manitoba, CanadaThe present report documents a 49-year-old HIV-infected man receiving antiretroviral therapy with a suboptimal immune response and a CD4 count of 95 cells/mm3, despite virological suppression. Investigation of bone marrow was conducted and yielded a diagnosis of visceral leishmaniasis. The clinical course was complicated by gastrointestinal involvment and relapse occurred after amphotericin B therapy. With the addition of miltefosine, the patient no longer presented with bone marrow amastigotes, and displayed an increased CD4 count and negative Leishmania polymerase chain reaction results. The present case highlights atypical presentation of visceral leishmaniasis, including poor immune reconstitution and gastrointestinal involvement. The high likelihood of relapse and response to combination therapy are illustrated.http://dx.doi.org/10.1155/2015/176545 |
| spellingShingle | Shauna McQuarrie Ken Kasper Dana C Moffatt Daniel Marko Yoav Keynan Relapse of Visceral Leishmaniasis in an HIV-Infected Patient Successfully Treated with a Combination of Miltefosine and Amphotericin B Canadian Journal of Infectious Diseases and Medical Microbiology |
| title | Relapse of Visceral Leishmaniasis in an HIV-Infected Patient Successfully Treated with a Combination of Miltefosine and Amphotericin B |
| title_full | Relapse of Visceral Leishmaniasis in an HIV-Infected Patient Successfully Treated with a Combination of Miltefosine and Amphotericin B |
| title_fullStr | Relapse of Visceral Leishmaniasis in an HIV-Infected Patient Successfully Treated with a Combination of Miltefosine and Amphotericin B |
| title_full_unstemmed | Relapse of Visceral Leishmaniasis in an HIV-Infected Patient Successfully Treated with a Combination of Miltefosine and Amphotericin B |
| title_short | Relapse of Visceral Leishmaniasis in an HIV-Infected Patient Successfully Treated with a Combination of Miltefosine and Amphotericin B |
| title_sort | relapse of visceral leishmaniasis in an hiv infected patient successfully treated with a combination of miltefosine and amphotericin b |
| url | http://dx.doi.org/10.1155/2015/176545 |
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