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Am. J. Trop. Med. Hyg., 73(1), 2005, pp. 67-68
Copyright © 2005 by The American Society of Tropical Medicine and Hygiene

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BRIEF REPORT


MILD, SELF-RESOLVING ACUTE LEPTOSPIROSIS IN AN HIV-INFECTED PATIENT IN THE PERUVIAN AMAZON

CHRISTIAN A. GANOZA, EDDY R. SEGURA, MARK A. SWANCUTT, EDUARDO GOTUZZO, AND JOSEPH M. VINETZ*
Alexander von Humboldt Institute of Tropical Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru; Division of Infectious Diseases, Department of Medicine, University of California, San Diego La Jolla, California

 

ABSTRACT

We report a case of acute, self-resolving leptospirosis presenting in a HIV-positive patient from the Peruvian Amazon. The patient presented with an undifferentiated acute febrile illness that resolved without treatment, diagnosed retrospectively as leptospirosis by serology and real-time polymerase chain reaction. Five months later, he was admitted because of a febrile illness with jaundice, hepatosplenomegaly, peripheral edema, and oral candidiasis. Because of the clinical suspicion of AIDS, stored sera of the previous admission were tested, and HIV seropositivity was confirmed, proving that the condition was present at the first admission. Acute leptospirosis in HIV coinfection is not inevitably severe, and there is probably a wide variation in clinical manifestations similar to what occurs in immuno-competent hosts.

Received December 8, 2004. Accepted for publication January 22, 2005.

Acknowledgments: The study was approved by the UCSD Institutional Review Board and the Ethical Committee of the Universidad Peruana Cayetano Heredia.

Financial support: This work was supported by NIH/Fogarty International Center grants R01-TW05860 and D43TW007120.

* Address correspondence to Joseph M. Vinetz, Division of Infectious Diseases, University of California San Diego School of Medicine, 9500 Gilman Drive, 0640, La Jolla, California. E-mail: jvinetz{at}ucsd.edu

Authors’ addresses: Christian A. Ganoza, Eddy R. Segura, and Edu-ardo Gotuzzo, Instituto de Medicina Tropical Alexander von Hum-boldt, Universidad Peruana Cayetano Heredia, A.P. 4314, Lima 100, Peru. E-mail: cganoza{at}hotmail.com, cganoza{at}hotmail.com, eddysegura{at}hotmail.com, and egh{at}upch.edu.pe., and egh{at}upch.edu.pe Mark A. Swancutt and Joseph M. Vinetz, Division of Infectious Diseases, University of California San Diego School of Medicine, 9500 Gilman Drive, 0640, LaJolla, CA 92093-0640. E-mail: mswancutt{at}ucsd.edu and jvinetz{at}ucsd.edu






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