Coinfection of Leishmania guyanensis and Human Immunodeficiency Virus–Acquired Immune Deficiency Syndrome: Report of a Case of Disseminated Cutaneous Leishmaniasis in Ecuador

Manuel Calvopina Carrera de Medicina, Universidad De Las Americas (UDLA), Quito, Ecuador.

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Cristina Aguirre Servicio de Medicina Interna, Hospital Eugenio Espejo, Quito, Ecuador.

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William Cevallos Carrera de Medicina, Universidad Central del Ecuador, Quito, Ecuador.

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Alberto Castillo Servicio de Medicina Interna, Hospital Eugenio Espejo, Quito, Ecuador.

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Ibrahim Abbasi The Kuvin Center for the Study of Infectious and Tropical Diseases, The Hebrew University of Jerusalem, Jerusalem, Israel.

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Alon Warburg The Kuvin Center for the Study of Infectious and Tropical Diseases, The Hebrew University of Jerusalem, Jerusalem, Israel.
PROMETEO, Secretaría Nacional de Educación Superior, Ciencia, Tecnología e Innovación (SENESCYT), Ecuador.

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Reported herein is the first case of Leishmania–human immunodeficiency virus (HIV) coinfection in Ecuador. In Ecuador, HIV infections overlap endemic areas of leishmaniasis. Immunosuppression is a well-established risk factor for developing severe disease. This is a severe case of a 32-year-old man presenting with disseminated pleomorphic ulcers, papules, and cutaneous plaque-like lesions over his whole body. Numerous amastigotes were observed in both skin scrapings and biopsies. The sequence of the cytochrome b gene confirmed the presence of Leishmania guyanensis. The patient was treated but failed to respond to meglumine antimoniate and amphotericin B. Six months later, the patient died due to bacterial septic shock.

Author Notes

* Address correspondence to Manuel Calvopina, Universidad De Las Américas (UDLA), Avenida de Granados E11-41 y Colimies, P.O. Box 17-17-9788, Quito, Ecuador. E-mails: manuelcalvopina@gmail.com or manuel.calvopina@udla.edu.ec

Authors' addresses: Manuel Calvopina, Universidad De Las Américas (UDLA), Quito, Ecuador, E-mails: manuelcalvopina@gmail.com or manuel.calvopina@udla.edu.ec. Cristina Aguirre and Alberto Castillo, Servicio de Medicina Interna, Hospital Eugenio Espejo, Quito, Ecuador, E-mails: crisvane_1210@hotmail.com and ixsoon@yahoo.es. William Cevallos, Carrera de Medicina, Universidad Central del Ecuador, Quito, Ecuador, E-mail: wcevallos@uce.edu.ec. Ibrahim Abbasi and Alon Warburg, The Kuvin Center for the Study of Infectious and Tropical Diseases, The Hebrew University of Jerusalem, Jerusalem, Israel, E-mails: ibrahima@ekmd.hiju.ac.il and alonw@ekmd.huji.ac.il.

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