DUODENAL LEISHMANIASIS DIAGNOSED BY BIOPSY IN 2 HIV-POSITIVE PATIENTS

We describe two cases of duodenal leishmaniasis in patients with human immunodeficiency virus (HIV) infection, diagnosed by light and electr on microscopy. The patients presented nonspecific signs and symptoms, blood cultures were sterile, and serological tests for Leishmania spp. were negative. Endoscopy showed normal-appearing mucosa in one patien t and possible peptic duodenitis in the other patient. In these patien ts, the parasite was only detected in a duodenal biopsy specimen. In v iew of the unusual location of the parasite and the fact that the diag nosis and dissemination of the disease was established by means of con ventional biopsy, this is not a routine procedure for the diagnosis of leishmaniasis because the classic procedures require the demonstratio n of antibodies and visualization in bone marrow, lymph nodes, liver a nd/or spleen aspirates. We decided to report these two cases to call a ttention to the possible finding of Leishmania amastigotes in biopsies from intestinal mucosa in HIV infected patients.