About this Journal Submit a Manuscript Table of Contents
Case Reports in Medicine
Volume 2012 (2012), Article ID 240512, 4 pages
http://dx.doi.org/10.1155/2012/240512
Case Report

Dyarrheal Syndrome in a Patient Co-Infected with Leishmania infantum and Schistosoma mansoni

1Hospital Eduardo de Menezes, Fundação Hospitalar do Estado de Minas Gerais (Fhemig), Rua Dr Cristiano Resende, 2213, 30622-020 Belo Horizonte, MG, Brazil
2Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou, Instituto Oswaldo Cruz-FIOCRUZ, Avenida Augusto de Lima, 1715, 30190-002 Belo Horizonte, MG, Brazil
3Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz-FIOCRUZ, Avenida Brasil, 4365, 21040-360 Manguinhos, Rio de Janeiro, RJ, Brazil
4Departamento de Patologia Geral, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, 31270-901 Belo Horizonte, MG, Brazil

Received 20 July 2012; Accepted 16 October 2012

Academic Editor: Stephen P. Peters

Copyright © 2012 Gláucia Fernandes Cota et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This case report describes an atypical clinical presentation of visceral leishmaniasis affecting the digestive tract and causing malabsorption syndrome in a patient without recognized immunosuppressive condition. After appropriate treatment for the classical visceral form of the disease, diarrhea persisted as the main symptom and massive infection by Leishmania was detected by histopathology analysis of the duodenal mucosa. Schistosoma mansoni coinfection was also confirmed and treated without impact on diarrhea. New course of amphotericin B finally led to complete improvement of diarrhea. Atypical visceral leishmaniasis involving the gastrointestinal tract is well recognized in HIV coinfection but very rare in immunocompetent patients. The factors determining the control or evolution of the Leishmania infection have not been completely identified. This case stresses the importance of atypical symptoms and the unusual location of visceral leishmaniasis, not only in immunodepressed patients, and raises the possible influence of chronic infection by S. mansoni reducing the immune response to Leishmania.