Microscopy and Polymerase Chain Reaction Detection ofLeishmania chagasiin the Pleural and Ascitic Fluid of a Patient with AIDS: Case Report and Review of Diagnosis and Therapy of Visceral Leishmaniasis
Atypical visceral leishmaniasis is increasingly reported in immunocompromised patients, including patients with AIDS. A case of visceral leishmaniasis in an HIV-infected Brazilian patient with pulmonary and peritoneal involvement is reported. Histological evaluation of pleural fluid and ascites aspirate revealed macrophages with intracellularLeishmania. Polymerase chain reaction analysis was positive forLeishmaniain the pleural and ascitic fluid with use of primers specific forLeishmania chagasi. In addition to classical methods for diagnosing leishmaniasis, such as microscopy and culture, polymerase chain reaction detection and identification ofLeishmaniaspecies in pleural effusions and ascites are important diagnostic tools that should be considered by clinicians evaluating HIV-infected patients from endemic areas of visceral leishmaniasis. The authors review the clinical manifestations, diagnostic and therapeutic aspects of visceral leishmaniasis in immunocompetent and HIV-infected patients.