Leishmania infantum leishmaniasis in corticosteroid – treated patients

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

Clinical corse of classic Kaposi’s sarcoma in HIV-negative patients treated with the HIV protease inhibitor indinavir.

HIV protease inhibitors (HIV-PI) have been shown to exert anti-angiogenic and anti-tumor actions independently from their antiretroviral effect. Based on these studies, HIV-seronegative patients with classic Kaposi’s sarcoma were treated with Indinavir and followed for clinical evolution, drug pharmacokinetics and KS biomarkers. A favorable clinical course was associated with high drug plasma levels, reduced production of basic fibroblast growth factor, lower numbers of circulating endothelial cell numbers, and a decrease of antibody titers against HHV8