Gastric localization of Leishmania in a patient with acquired immunodeficiency syndrome. A case report

We report a case of gastric localization of Leishmania in a 29-year old man affected by AIDS. Gastric biopsies revealed macrophages infected with intracytoplasmic organisms attributable to Leishmania amastigotes. The authors emphasize the importance of performing random biopsies in the absence of endoscopic abnormalities.

Mediterranean visceral leishmaniasis in pregnancy

Visceral leishmaniasis (VL) in pregnancy is rare in Mediterranean countries. We report here 2 cases of VL in pregnant women who acquired the infection in Italy. In the first case, the disease was diagnosed and treated with liposomal amphotericin B during the pregnancy. In the second case, diagnosis was established and treatment with meglumine antimoniate both undertaken shortly after delivery. The 2 infants were followed clinically and serologically for 8-9 months after birth, but no evidence of congenital VL was observed.

HIV-Leishmania co-infections in Italy: serological data as an indication of the sequence of acquisition of the two infections

Twenty-two sera from visceral leishmaniasis (VL) patients with human immunodeficiency virus (HIV) infection (50% with the acquired immune deficiency syndrome) were examined for anti-Leishmania immunoglobulin G (IgG) antibodies and compared with 35 sera from VL patients without HIV (controls). Significant titres of specific IgG were found in 81.8% of co-infections. However, while control sera showed a restricted range of anti-Leishmania IgG titres, sera from co-infection cases displayed a considerable degree of variability, both quantitative and qualitative. They were clearly divided into 2 groups: one (18 sera) showing a continuous grading from nil to mid-concentrations of specific antibodies, the other (3 sera) showing titres 30-fold higher than this range. Taking into account the major immunological abnormalities involving humoral response described in HIV patient, the 2 groups may reflect a different sequence of acquisition of the 2 infective agents; the former representing VL acquired after HIV infection, and the latter representing the contrary situation.