HAEMOCULTURE AS A TOOL FOR DIAGNOSING VISCERAL LEISHMANIASIS IN HIV-NEGATIVE AND HIV-POSITIVE PATIENTS - INTEREST FOR PARASITE IDENTIFICATION

Between May 1993 and June 1996 65 adults infected with human immunodef iciency virus (HIV) and 30 HIV-negative patients (8 children and 22 ad ults) from the Mediterranean region with symptoms that included at lea st fever were examined for Leishmania. A total of 128 bone marrow and 128 peripheral venous blood samples were taken and cultured on NNN med ium. At the initial diagnosis, 14 (6 HIV-positive and 8 HIV-negative) of 15 patients with a positive blood culture also had a positive bone marrow culture. Two patients (I HIV-positive and the other HIV-negativ e) had a positive bone marrow culture but a negative blood culture. Du ring post-therapeutic check-ups, 7 out of 8 patients with a positive b lood culture (6 HIV-positive and I HIV-negative) also had a positive b one marrow culture. On the other hand, three patients (2 HIV-positive and 1 HIV-negative) had a positive bone marrow but a negative blood cu lture. Relapses were more frequent (9/65 vs. 3/30) and the demonstrati on of Leishmania in the blood was commoner (6/65 vs. 2/30) in the HIV- positive than the HIV-negative patients, Stocks were identified by the ir isoenzymes: MON-I from four HIV-positive and eight HIV-negative pat ients, MON-28 from one HIV-positive patient and MON-29 from another Fo r each patient, the same zymodeme was found in bone marrow and blood c ultures, both at initial diagnosis and at follow-up.