Disseminated cutaneous Leishmaniasis in a patient who is HIV positive with a flare up as iris -a case report
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2018, Vol 3, Issue 10
Abstract
There is a broad spectrum of clinical manifestations of cutaneous leishmaniasis. The usual lesion is a small, red papule which over several weeks becomes darker, crusts in the centre and eventually ulcerates & heals, leaving a raised border. A rare form is the disseminated (diffuse) cutaneous leishmaniasis which can occur among immunosuppressed persons where lesions begin with an initial primary lesion and then disseminates to involve other areas of the skin. The lesions are non ulcerative nodules full of parasites, and are often scattered over the limbs, buttocks, and face. The disease does not involve internal organs. 32 yrs old male presented with multiple swellings in different parts of body with itching. O/E multiple plaques, sub cutaneous nodules and molluscum like lesions were present over extremities and trunk. Biopsy from multiple sites was similar and suggestive of Leishmaniasis. Treated with sodium stibogluconate and lesions responded. 5 months after ART he presented with generalised plaques and oedematous red lesions resembling photo dermatitis. Repeat skin biopsy showed same picture. Treated with sodium stibogluconate again and for past 4yrs he is asymptomatic. Cutaneous leishmaniasis is caused by different species of genus Leishmania, a protozoon that is transmitted by sand-flies. The result of infection varies from a cutaneous ulcer, to erosive mucosal disease with severe facial disfigurement, to a life threatening systemic infection, depending upon the interaction between Leishmania and the genetic and immunological status of the host. Leishmaniasis and HIV co-infection may intensify the immune defect and is the chief reason for atypical presentation and widespread progression of cutaneous leishmaniasis and its defiance to conventional therapy. IRIS whether paradoxical worsening or unmasking form is very common event after initiation of HAART, especially if CD4 is very low. Paradoxical worsening of diffuse cutaneous Leishmaniasis is still very uncommon.
Authors and Affiliations
Dr Sheela Mathew
Keywords
Related Articles
- EP ID EP519780
- DOI -
- Views 119
- Downloads 0
A Study Among Ischemic Stroke Patients To Predict 30 Day Functional Outcome Using National Institute Of Health Stroke Scale And Barthel Index In A Tertiary Health Care Centre.
Background: NIHSS is a well validated tool to evaluate the initial severity of acute ischemic stroke. It has mortality prediction value, but 30-day mortality risk is not well studied before. Aims &Objective: To find out...
To Evaluate The Effect Of Storage Medium On Fracture Resistance Of Reattached Tooth Fragments By Using Flowable Composite Resin
AIM: To compare the fracture resistance of fractured incisor tooth fragments stored in four different storage media after reattachment. Materials and methods: Sixty freshly extracted human maxillary incisors were includ...
Enamel Hypoplasia Enhancing Esthetics with Direct Composite Veneering Using IPS Empress Direct - A Case Report
Enamel hypoplasia affects the hard tissues of the teeth. It occurs due to disturbances during the formation of the tooth. It often leads to unesthetic appearance due to pitting and yellowish or brownish appearance of the...
A Study on Occurrence of Attention Deficit Hyperactivity Disorder in Patients with Febrile Seizures Presenting To Pediatric Hospital, Bikaner, Rajasthan.
Introduction: Febrile Seizures (F.S) and Attention-Deficit/Hyperactivity Disorder (ADHD) are disorders of the central nervous system and share common risk factors. The relationship between two remains enigmatic. There is...
Preemptive Analgesic Effects of 1 Gm Paracetamol Infusion on The Total Requirement of Tramadol In The Postoperative Period Including Rescue Analgesia.
Introduction: Most common symptoms which follow anaesthesia and surgery are pain and emesis. Pain relief after surgical procedures continues to be a major medical challenge. Aims and Objective : To study preemptive analg...