Abstract
Visceral leishmaniasis (VL) is generally associated with severe immunodeficiency (AIDS;
renal, liver, and heart transplantations; haemopoietic malignancies). More rarely
it can be related to an immunotolerence status such as pregnancy. Various observations
report the development of leishmaniasis several months or even years after exposure
to the parasite. Relapses occur rarely in patients not known to be immunocompromised,
but are common after incomplete treatment. They are frequent in patients with Leishmania/HIV co-infection. Asymptomatic phases and relapses suggest that parasite can exist in
the tissues for a long time before and/or after clinical onset of the disease.
The mechanisms of onset of clinical leishmaniasis following exposure and infestation
are highly relevant to understanding the pathology of the disease. The survival of
Leishmania parasite between infection and disease or after cure is a very important issue for
clinicians and epidemiologists. We describe two cases of VL occurring in a patient
with lymphoma and in a pregnant woman. In both cases, parasites remained present in
the lymph nodes after clinical cure.
Keywords
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© 2003 The British Infection Society. Published by Elsevier Inc. All rights reserved.
