Bronchopulmonary and mediastinal leishmaniasis: An unusual clinical presentation of Leishmania donovani infection

We describe a case of unusual leishmaniasis in a Sudanese man with a histor y of progressively enlarging granulomatous mediastinal lymphadenopathy, wor sening hemoptysis, and an intense mucosal granulomatous inflammatory respon se in the large bronchi, Leishmania donovani DNA was detected in bronchial biopsies by polymerase chain reaction. This is a novel description of human leishmanial infection in an immunocompetent patient involving this anatomi cal site. The patient's condition improved clinically, spirometrically, and radiologically after a course of treatment with amphotericin B, The cell-m ediated immune response was analyzed before, during, and after successful a ntileishmanial chemotherapy.