1Department of Internal Medicine, University of Gondar, Gondar, Ethiopia.
2Leishmaniasis Research and Treatment Center, University of Gondar, Gondar, Ethiopia.
Am J Trop Med Hyg. 2021 Apr 12;104(6):2082-2084. doi: 10.4269/ajtmh.20-0666.
Human visceral leishmaniasis (VL) is a life-threatening disease caused by protozoan parasites belonging to the Leishmania donovani complex. Atypical cases of leishmaniasis and HIV coinfection have been documented in case reports, mostly associated with gastrointestinal tract, kidney, and skin involvement. We report two VL cases with atypical localizations not reported from east Africa before, both diagnosed and treated at the Leishmaniasis Research and Treatment Center, Gondar, Ethiopia. The first case was an HIV-infected patient with scrotal and penile involvement. Leishmania parasites were detected in the spleen and the scrotum. The second case was an immunocompetent individual with esophageal, laryngeal, and pharyngeal involvement and facial lesions. Leishmania parasites were detected in the spleen, skin, and esophageal biopsies. Current evidence suggests atypical presentation can occur in patients irrespective of their HIV status. Therefore, we suggest a high index of suspicion for VL among clinicians working in endemic areas of Ethiopia.
人体内脏利什曼病（VL）是一种危及生命的疾病，由属于利什曼原虫复合体的原生动物寄生虫引起。在病例报告中记录了利什曼病和 HIV 合并感染的不典型病例，主要与胃肠道、肾脏和皮肤受累有关。我们报告了两例来自东非以前未报道过的不典型定位的 VL 病例，均在埃塞俄比亚贡德尔利什曼病研究和治疗中心诊断和治疗。第一例是一名感染 HIV 的患者，阴囊和阴茎受累。在脾脏和阴囊中检测到利什曼原虫。第二例是一名免疫功能正常的个体，食管、喉部和咽部受累和面部病变。在脾脏、皮肤和食管活检中检测到利什曼原虫。现有证据表明，无论 HIV 状况如何，患者都可能出现不典型表现。因此，我们建议在埃塞俄比亚流行地区工作的临床医生对 VL 保持高度警惕。
