Diagnosis of visceral leishmaniasis in HIV-infected individuals using peripheral blood smears

AIDS. 1993 Feb;7(2):227-30. doi: 10.1097/00002030-199302000-00011.


Objective: To compare the clinical and laboratory features of visceral leishmaniasis (kala-azar) in HIV-infected and non-infected subjects, and to determine the presence of Leishmania amastigotes in circulating leukocytes using peripheral blood smears.

Patients: Twenty-eight HIV-infected and six HIV-negative adult patients diagnosed as having kala-azar presenting at one institution over a 7-year period.

Methods: Retrospective review of clinical charts and re-examination of peripheral blood smears.

Results: There were no significant differences in the clinical presentation and laboratory features of HIV-positive and HIV-negative patients. However, Leishmania amastigotes were observed in circulating leukocytes in eight out of the 17 available peripheral blood smears (15 from HIV-infected patients). All eight individuals presenting with Leishmania in peripheral blood leukocytes were HIV-positive.

Conclusions: Direct visualization of Leishmania amastigotes in leukocytes on peripheral blood smears enabled the diagnosis of kala-azar in a high proportion [eight out of 15 (53%)] of our HIV-infected patients.

MeSH terms

  • AIDS-Related Opportunistic Infections / diagnosis*
  • AIDS-Related Opportunistic Infections / parasitology
  • Adult
  • Animals
  • Female
  • HIV Infections / complications*
  • Humans
  • Leishmania donovani / isolation & purification
  • Leishmaniasis, Visceral / complications*
  • Leishmaniasis, Visceral / diagnosis*
  • Leishmaniasis, Visceral / parasitology
  • Leukocytes / parasitology
  • Male
  • Middle Aged