Alonso M J, Muñoz E, Picazo A, Abad M M, Gómez F, Roldán M, Laguna F, Paz J I, López-Bravo A
Department of Pathology, National Cancer for Clinical Research and Preventive Medicine (Institute of Health Carlos III), Madrid, Spain.
Pathol Res Pract. 1997;193(1):43-7; discussion 49-50. doi: 10.1016/s0344-0338(97)80092-1.
We describe two cases of duodenal leishmaniasis in patients with human immunodeficiency virus (HIV) infection, diagnosed by light and electron microscopy. The patients presented nonspecific signs and symptoms, blood cultures were sterile, and serological tests for Leishmania spp. were negative. Endoscopy showed normal-appearing mucosa in one patient and possible peptic duodenitis in the other patient. In these patients, the parasite was only detected in a duodenal biopsy specimen. In view of the unusual location of the parasite and the fact that the diagnostic and dissemination of the disease was established by means of conventional biopsy, this is not a routine procedure for the diagnosis of leishmaniasis because the classic procedures require the demonstration of antibodies and visualization in bone marrow, lymph nodes, liver and/or spleen aspirates. We decided to report these two cases to call attention to the possible finding of Leishmania amastigotes in biopsies from intestinal mucosa in HIV infected patients.
我们描述了两例人类免疫缺陷病毒（HIV）感染患者的十二指肠利什曼病病例，通过光学显微镜和电子显微镜诊断。患者表现出非特异性体征和症状，血培养无菌，利什曼原虫属的血清学检测为阴性。内镜检查显示，一名患者的黏膜外观正常，另一名患者可能患有消化性十二指肠炎症。在这些患者中，仅在十二指肠活检标本中检测到寄生虫。鉴于寄生虫的位置不寻常，且通过传统活检确定了疾病的诊断和传播，这并非诊断利什曼病的常规程序，因为经典程序需要在骨髓、淋巴结、肝脏和/或脾脏穿刺物中证明抗体并进行可视化。我们决定报告这两例病例，以引起对HIV感染患者肠道黏膜活检中可能发现利什曼无鞭毛体的关注。
