Albrecht H, Sobottka I, Emminger C, Jablonowski H, Just G, Stoehr A, Kubin T, Salzberger B, Lutz T, van Lunzen J
Department of Internal Medicine, University Clinic Eppendorf, Hamburg, Germany.
Arch Pathol Lab Med. 1996 Feb;120(2):189-98.
Visceral leishmaniasis is an important infection in patients infected with human immunodeficiency virus and living in areas endemic for Leishmania sp. Leishmaniasis, however, is rarely suspected in patients residing in nonendemic countries.
Retrospective case analysis of 15 patients with human immunodeficiency virus infection and leishmaniasis treated at seven German clinics. The clinicopathological features and the diagnostic role of biopsy and/or cytology as compared to serology were evaluated.
All patients were severely immunocompromised. One patient was first diagnosed at autopsy. One patient with mucocutaneous disease was diagnosed by nasal biopsy. All others had amastigotes detected in bone marrow (13/13), liver (3/3), and gastrointestinal mucosa (4/4). Serology was positive in only 6 or 13.
Visceral leishmaniasis is an important opportunistic infection in patients with acquired immunodeficiency syndrome and it must be ruled out in every patient with fever and/or pancytopenia and an appropriate travel history. Because serological diagnosis is often insufficient, pathologists must be aware of the association between human immunodeficiency virus infection and leishmaniasis. Diagnosis depends on detection of the parasite in submitted specimens.
内脏利什曼病在感染人类免疫缺陷病毒且生活在利什曼原虫属流行地区的患者中是一种重要感染。然而，在非流行国家居住的患者中很少怀疑患有利什曼病。
对在德国七家诊所接受治疗的15例人类免疫缺陷病毒感染合并利什曼病患者进行回顾性病例分析。评估了临床病理特征以及活检和/或细胞学与血清学相比的诊断作用。
所有患者均严重免疫功能低下。1例患者首次在尸检时被诊断。1例皮肤黏膜疾病患者通过鼻活检确诊。所有其他患者在骨髓（13/13）、肝脏（3/3）和胃肠道黏膜（4/4）中检测到无鞭毛体。血清学仅在6/13中呈阳性。
内脏利什曼病是获得性免疫缺陷综合征患者的一种重要机会性感染，对于每一位有发热和/或全血细胞减少且有适当旅行史的患者都必须排除该病。由于血清学诊断往往不足，病理学家必须了解人类免疫缺陷病毒感染与利什曼病之间的关联。诊断取决于在所提交标本中检测到寄生虫。
