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Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 15, Issue 4, Pages 231-234
Case Report

Microscopy and Polymerase Chain Reaction Detection of Leishmania chagasi in the Pleural and Ascitic Fluid of a Patient with AIDS: Case Report and Review of Diagnosis and Therapy of Visceral Leishmaniasis

Ada RS Diehl, Rodrigo P dos Santos, Ricardo Zimmerman, Letícia P Luz, Tanara Weiss, Pedro Jacobson, and Luciano Z Goldani

Section of Infectious Diseases and Section of Cytopathology Laboratory, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil

Received 7 January 2004; Accepted 20 July 2004

Copyright © 2004 Hindawi Publishing Corporation. 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.


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 intracellular Leishmania. Polymerase chain reaction analysis was positive for Leishmania in the pleural and ascitic fluid with use of primers specific for Leishmania chagasi. In addition to classical methods for diagnosing leishmaniasis, such as microscopy and culture, polymerase chain reaction detection and identification of Leishmania species 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.