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Open Access Case report

Leishmania infantum leishmaniasis in corticosteroid – treated patients

Silvia Pittalis, Emanuele Nicastri*, Francesco Spinazzola, Piero Ghirga, Michele De Marco, Maria Grazia Paglia and Pasquale Narciso

Author Affiliations

National Institute for Infectious Diseases IRCCS L. Spallanzani Rome Italy

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BMC Infectious Diseases 2006, 6:177  doi:10.1186/1471-2334-6-177

Published: 18 December 2006

Abstract

Background

The number of leishmaniasis cases associated with immunosuppression has increased regularly over the past 20 years. Immunosuppression related to HIV infection, immunosuppressive treatment, organ transplantation, and neoplastic diseases increases the risk for Leishmania-infected people to develop visceral illness.

Case presentation

Three cases of Leishmania infantum leishmaniasis in corticosteroid (CS)-treated patients are reported: an isolated lingual leishmaniasis in a farmer treated with CS for asthma, a severe visceral leishmaniasis associated with cutaneous lesions in a woman with myasthenia gravis, and a visceral involvement after cutaneous leishmaniasis in a man receiving CS.

Conclusion

Physicians should recognise CS-treated patients as a population likely to be immunesuppressed. In immunodeficiency conditions, unusual forms of leishmaniasis can develop and foster the risk of a diagnostic delay and of poor response to therapy.