Cutaneous Leishmaniasis in a Patient with Retroviral Disease and Disseminated Tuberculosis Co-Infection: A Case Report

• ¹Usmanu Danfodiyo University Sokoto, Federal Teaching Hospital Katsina,

Cutaneous Leishmaniasis is one of the forms of leishmaniasis caused by the parasitic disease transmitted by Phlebotomous sandflies. There are about fifteen different species. This is not life-threatening but can leave permanent skin-disfiguring lesions. It is among the Neglected Tropical Diseases (NTDs) and about 95% of new cases of cutaneous leishmaniasis occur in the Americas, the Mediterranean basin, the Middle East, and Central Asia.  HIV is a risk factor and Co-infection with Leishmaniasis has been well-documented. The first cases of HIV-leishmaniasis co-infection were described in Spain in the late 1980s. In the 1990s more than 90% of co-infection cases were reported in southern Europe. With the introduction of combination antiretroviral therapy (ART), the incidence decreased substantially in developed countries, but HIV-leishmaniasis co-infection poses a growing problem in parts of Asia, Africa, and Latin America.

The index case is a 53-year-old male businessman who travels across the country, his recent visits were to Maradi in Niger Republic and Sokoto state and attest to sleeping outdoors with no Mosquito net. He is a known HIV patient for >1 year on Tenofovir+Lamivudine+Dolutegravir (TLD). He was admitted with six (6) months of complaining of progressively enlarging nodular lesions on the face, pinna upper trunk, and upper arms, and lower limb weakness. . Histology reveals the presence of atropic keratinized squamous epithelium. The underlying dermis exhibits intense lymphoplasmacytic and histiocytic infiltrations. Several of the histiocytes exhibit Donovan like bodies. Spinal MRI findings were suggestive of potts disease.