DOUBLE BURDEN OF CUTANEOUS AND VISCERAL LEISHMANIASIS IN HIV: A CASE REPORT

Introduction: Leishmaniasis is a vector-borne infection caused by an obligate intracellular protozoon, Leishmania species, which is transmitted by phlebotomine sandflies. The human leishmaniases are usually classified as visceral, localized cutaneous, diffuse cutaneous or muco?cutaneous and their manifestations can present a wide clinical spectrum depending upon type, virulence and immune response of the infected person. Since HIV infection has extended to areas in which human leishmaniasis is endemic, the incidence of human leishmaniasis is on a rise. However cases with cutaneous and visceral leishmaniasis together in HIV patient are extremely rare. Case Presentation: A 47 year male came with complaint of painful nodular lesion over hands and bridge of the nose since 8 month. Patient was diagnosed with HIV in 1994 and started on treatment in 2010. Cutaneous examination, biopsy of nodular lesion and bone marrow aspirate showed evidence of both cutaneous and visceral leishmaniasis. Patient was treated with Amphoterecin and on follow up showed improvement.Conclusions: It is better to evaluate the diagnosis of visceral leishmaniasis in patients who present with cutaneous leishmaniasis and HIV infection. Immediate, complete, and effective treatment of both HIV infection and visceral leishmaniasis is mandatory in these patients.