CASE REPORT
Unusual duodenal presentation of leishmaniasis
1 Geriatrics Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
2 Department of Pathology, Hospital General Universitario Gregorio Marañón
Correspondence to:
Correspondence to:
Dr M L Álvarez-Nebreda
Geriatrics Department, Hospital General Universitario Gregorio Marañón, calle Doctor Esquerdo 46, 28007 Madrid, Spain; alvareznebreda{at}yahoo.es
This case report describes an atypical case of duodenal leishmaniasis in an elderly patient not infected with human immunodeficiency virus. Investigation of this 84 year old woman with a constitutional syndrome and dysphagia revealed anaemia of chronic disorder, a high erythrocyte sedimentation rate, and polyclonal hypergammaglobulinaemia. Abdominal ultrasonography revealed thickening of the stomach wall, which was seen to be inflamed during gastroscopy. Duodenal histology revealed numerous leishmania amastigotes within macrophages. This was confirmed by bone marrow biopsy and leishmania serology. This case report stresses the importance of atypical symptoms and the unusual location of visceral leishmaniasis, not only in immunodepressed patients, but also in elderly immunocompetent patients.
Abbreviations: HIV, human immunodeficiency virus
Keywords: visceral leishmaniasis; elderly; human immunodeficiency virus; duodenal infection
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Endoscopy
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Sexual transmitted infections (viral)
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Oesophagus
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Immunology (including allergy)
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