The changing spectrum of cutaneous leishmaniasis and HIV coinfection in Bolivian Amazonia: a case report.
Alfonso Gotor-Rivera, Mayber Lenin Aparicio-Loayza, Rodrigo Federico Matilla Naumionek et al.
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Case in brief
A 34-year-old man with advanced HIV infection presented with localized cutaneous leishmaniasis that progressed despite treatment with pentavalent antimonials. He developed numerous widespread ulcerated papules and nodules, along with systemic symptoms and significant weight loss. Diagnosis was confirmed through skin smears and histopathology showing intracellular amastigotes. Treatment with liposomal amphotericin B and oral miltefosine resulted in only temporary clinical improvement.
Diagnostic / clinical pearl
Clinicians should be aware of the potential for cutaneous leishmaniasis to present atypically and progress rapidly in immunocompromised patients, complicating diagnosis and treatment.
Why it matters
This case illustrates the evolving clinical spectrum of cutaneous leishmaniasis in the context of HIV, emphasizing the need for heightened awareness and tailored management strategies in such patients.