Gastric leishmaniasis in an immunocompromised patient: a case report

Abstract

Leishmaniasis is a tropical infection that usually presents as a cutaneous, mucocutaneous, or visceral disease. The most common organs involved in visceral leishmaniasis are the liver, spleen, and bone marrow; involvement of the stomach is rare, with only a few cases reported to date. We present a 45-year-old male with acquired immunodeficiency syndrome (AIDS) and a history of visceral leishmaniasis. The patient was admitted to the hospital due to pancytopenia. During the workup, low vitamin B12 levels and elevated intrinsic factor antibodies raised suspicion of atrophic gastritis, prompting endoscopy for gastric mapping. The patient was diagnosed with gastric leishmaniasis. Several macrophages containing intracellular amastigotes were seen. PCR analysis of the bone marrow biopsy identified the organism as Leishmania donovani/infantum/chagasi . This case underscores the critical value of histologic examination, with the diagnosis relying on recognition based on routine histology, confirmed by molecular testing.