Dataset Information

Role of PCR in diagnosis and prognosis of visceral leishmaniasis in patients coinfected with human immunodeficiency virus type 1.

ABSTRACT: A group of 76 consecutive human immunodeficiency virus (HIV)-positive patients with fever of unknown origin (n = 52) or fever associated with pulmonary diseases was evaluated in order to assess the usefulness of PCR with peripheral blood in the diagnosis and follow-up of visceral leishmaniasis. We identified 10 cases of visceral leishmaniasis among the 52 patients with fever of unknown origin. At the time of diagnosis, all were parasitemic by PCR with peripheral blood. During follow-up, a progressive decline in parasitemia was observed under therapy, and all patients became PCR negative after a median of 5 weeks (range, 6 to 21 weeks). However, in eight of nine patients monitored for a median period of 88 weeks (range, 33 to 110 weeks), visceral leishmaniasis relapsed, with positive results by PCR with peripheral blood reappearing 1 to 2 weeks before the clinical onset of disease. Eight Leishmania infantum and two Leishmania donovani infections were identified by PCR-restriction fragment length polymorphism analysis. PCR with peripheral blood is a reliable method for diagnosis of visceral leishmaniasis in HIV-infected patients. During follow-up, it substantially reduces the need for traditional invasive tests to assess parasitological response, while a positive PCR result is predictive of clinical relapse.

SUBMITTER: Pizzuto M

PROVIDER: S-EPMC87731 | biostudies-literature | 2001 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Role of PCR in diagnosis and prognosis of visceral leishmaniasis in patients coinfected with human immunodeficiency virus type 1.

Pizzuto M M Piazza M M Senese D D Scalamogna C C Calattini S S Corsico L L Persico T T Adriani B B Magni C C Guaraldi G G Gaiera G G Ludovisi A A Gramiccia M M Galli M M Moroni M M Corbellino M M Antinori S S

Journal of clinical microbiology 20010101 1

A group of 76 consecutive human immunodeficiency virus (HIV)-positive patients with fever of unknown origin (n = 52) or fever associated with pulmonary diseases was evaluated in order to assess the usefulness of PCR with peripheral blood in the diagnosis and follow-up of visceral leishmaniasis. We identified 10 cases of visceral leishmaniasis among the 52 patients with fever of unknown origin. At the time of diagnosis, all were parasitemic by PCR with peripheral blood. During follow-up, a progre ...[more]

PMID: 11136800

Similar Datasets

Project description:Backgroundhuman immunodeficiency virus (HIV) can disrupt the body's immune system, increasing the chance of various opportunistic infections. The risk of misdiagnosis and underdiagnosis is high for HIV and Leishmania coinfection. Visceral leishmaniasis (VL) has become a significant opportunistic infection in HIV type 1 (HIV-1)-infected patients in the epidemic region. Co-infection is difficult to diagnose, especially in non-endemic areas.Case descriptionThis study presents a case of VL in a middle-aged male patient with HIV coinfection, where the diagnosis was circuitous and complex. The patient was a 44-year-old male who was hospitalized due to fever. We considered common pathogen infection or hemophagocytic syndrome, so we did various etiological examinations and bone marrow biopsy smears, but no positive pathogens were found. Then we used a variety of empirical treatment, but the patient's temperature did not drop significantly. After the final diagnosis of VL using metagenomic next-generation sequencing (mNGS), we read the bone marrow smear and biopsy specimens again, and ultimately the Leishman-Donovan body and tissue intracellular pathogens were found. The patient responded well to treatment with sodium stibogluconate (SSG), his temperature gradually recovered from hyperthermia to normal, liver and spleen size gradually decreased, hemoglobin and platelet count rebounded, and weight increased by 1.5 kg after discharge from the hospital. We hope to deepen clinicians' understanding of mNGS for VL diagnosis and provide a review of the literature.ConclusionsFor patients with HIV coinfection, mNGS-a test that can detect multiple pathogens simultaneously-can be used routinely when multiple pathogen tests showed no positive results, multiple empiric anti-infective therapies failed, and hospital technology and the patient's economy are adequate. While giving highly active antiretroviral therapy (HAART), liposomal amphotericin B (L-AMB) is highly recommended because of its better efficacy and lower side effects. Not only is the treatment of leishmaniasis critical but also follow-up at a later stage is essential. After discharged, the patient had no significant discomfort and no increase in body temperature, his hemoglobin and platelets increased further. He demonstrated a further reduction in liver and spleen size and a weight gain of 1.5 kg.

Dataset Information

Role of PCR in diagnosis and prognosis of visceral leishmaniasis in patients coinfected with human immunodeficiency virus type 1.

Publications

Role of PCR in diagnosis and prognosis of visceral leishmaniasis in patients coinfected with human immunodeficiency virus type 1.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets