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Case Reports in Infectious Diseases
Volume 2012, Article ID 787305, 3 pages
http://dx.doi.org/10.1155/2012/787305
Case Report

Clinical Challenges in the Management of Leishmania/HIV Coinfection in a Nonendemic Area: A Case Report

1Division of Immunology, Allergy and Infectious Diseases, Department of Dermatology, Medical University of Vienna, 1090 Vienna, Austria
2Department of Infectious Diseases and Tropical Medicine, Medical University of Vienna, 1090 Vienna, Austria
3Department of Dermatology and Venereology, Rudolfstiftung Hospital, 1030 Vienna, Austria

Received 1 November 2012; Accepted 5 December 2012

Academic Editors: L. M. Bush, M. Ghate, P. Horrocks, A. C. Sena, and E. M. Stringer

Copyright © 2012 K. Grabmeier-Pfistershammer 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

We report on a 37-year-old male HIV-positive patient with generalized cutaneous leishmaniasis undiagnosed for several years. Upon presentation, visceral leishmaniasis was diagnosed in addition to cutaneous manifestation of the disease. Over a period of three years, several different treatment regimens including liposomal amphotericin B, liposomal amphotericin B with miltefosine, liposomal amphotericin B with interferon, and pentamidine combined fluconazole and allopurinol were applied until Leishmania PCR from blood turned negative. This case supports the necessity of multidrug combinational and sequential therapy over a very prolonged period of time in severely immunosuppressed patients infected with Leishmania and highlights the tremendous individual but also economic burden of this disease.