Is Leishmania Infantum an Opportunistic Parasite in Patients With Anti—Human Immunodeficiency Virus Antibodies?

To the Editor.  —Leishmania infantum is the agent of an endemic anthropozoonosis in the Alpes-Maritimes department of France.¹ We report two cases of Mediterranean visceral leishmaniasis with anti—human immunodeficiency virus (anti-HIV) antibodies; at least one of the patients has acquired immunodeficiency syndrome (AIDS).

Report of Cases. 

—Case 1.  —A 39-year-old homosexual man was admitted for fever, diarrhea, and weight loss. He showed multiple enlarged lymph nodes and splenomegaly. Laboratory studies were as follows: white blood cell count, 3.3×1010⁹/L (3300/mm³); lymphocytes, 0.45×1010⁹/L (450/mm³); hemoglobin, 5.9 mmol/L (5.9 g/dL); platelet count, 75×1010⁹/L (75/mm³); gammaglobulin, 35 g/L (3.5 g/dL); anti-HIV antibodies, positive (enzymelinked immunosorbent assay [ELISA], Pasteur Institute, and Western blot); and T4 cell count, 0.04× 10⁹/L (4/mm³). Salmonella enteritidis was found in blood cultures, and Pneumocystis carinii was found in bronchoalveolar lavage specimens. Improvement was obtained with