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Human immunodeficiency virus (HIV) infection is increasing worldwide, and several reports indicate …

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- Oral ulcer as an unusual feature of visceral leishmaniasis in an AIDS patient

Leishmaniasis is a group of infections of the viscera, skin and mucous membrane, caused by protozoa of the genus Leishmania that is transmitted by sandflies of the genera Phlebotomus (old world leishmaniasis) and Lutzomyia (new world leishmaniasis). Promastigotes in the proboscis of a female sand fly are introduced into the skin of a vertebrate host during a blood meal. The promastigotes invade the reticuloendothelial cells, transform into amastigotes, multiply within the phagolysosomes and invade the other reticuloendothelial cells.

Clinically, leishmaniasis is seen as (1) visceral leishmaniasis (VL) - caused by Leishmania donovani , L. infantum, L. chagasi , leading to severe systemic infection, which may be accompanied by cutaneous manifestations; (2) cutaneous leishmaniasis - caused by L. tropica, L. aethiopica and L. infantum, in which there are cutaneous papules or nodules, and (3) mucocutaneous leishmaniasis - caused by L. Braziliensis , a zoonotic disease. The latter is characterized by primary cutaneous lesions that may be followed by destructive nasopharyngeal lesions several months later.[1]

Acquired immunodeficiency syndrome (AIDS) is characterized by numerous opportunistic infections. The association of AIDS with VL as an opportunistic infection has been frequently reported from the Mediterranean region.[2] Cases of VL in HIV patients have been reported[3],[4],[5] earlier from India, though only one with oral mucosal lesions so far.[6]

We report a case of VL with mucosal ulcer in an AIDS patient who belonged to a non-endemic area of western Uttar Pradesh in India.

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