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• W2142131853 abstract "Between May 1993 and June 1996, 65 adults infected with human immunodeficiency virus (HIV) and 30 HIV-negative patients (8 children and 22 adults) from the Mediterranean region with symptoms that included at least fever were examined for Leishmania. A total of 128 bone marrow and 128 peripheral venous blood samples were taken and cultured on NNN medium. 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 (1 HIV-positive and the other HIV-negative) had a positive bone marrow culture but a negative blood culture. During post-therapeutic check-ups, 7 out of 8 patients with a positive blood culture (6 HIV-positive and 1 HIV-negative) also had a positive bone marrow culture. On the other hand, three patients (2 HIV-positive and 1 HIV-negative) had a positive bone marrow but a negative blood culture. Relapses were more frequent (9/65 vs. 3/30) and the demonstration 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 their isoenzymes: MON-1 from four HIV-positive and eight HIV-negative patients, MON-28 from one HIV-positive patient and MON-29 from another. For each patient, the same zymodeme was found in bone marrow and blood cultures, both at initial diagnosis and at follow-up.The prevalence of visceral leishmaniasis (VL) has been steadily increasing throughout the Mediterranean region. In HIV-infected patients, severe disruption of the immune system renders the standard technique of antibody detection unreliable and diagnosis must be based on the detection of parasites in bone marrow smears or cultures. This study evaluated the relative efficiency of detecting Leishmania by culturing peripheral blood and bone marrow on NNN medium in 65 HIV-positive and 30 HIV-negative patients with suspected VL. 128 bone marrow and 128 peripheral venous blood samples were cultured. 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. 2 patients (1 HIV-positive and 1 HIV-negative) had a positive bone marrow culture but a negative blood culture. At post-therapeutic examination, 7 out of 8 patients with a positive blood culture (6 HIV-positive and 1 HIV-negative) also had a positive bone marrow culture, while 3 patients (2 HIV-positive and 1 HIV-negative) had a positive bone marrow but a negative blood culture. Relapses were more frequent among HIV-positive than HIV-negative patients (9/65 vs. 3/30) and the demonstration of Leishmania in the blood was more common (6/65 vs. 2/30). MON-1 was identified from 4 HIV-positive and 8 HIV-negative patients, MON-28 from 1 HIV-positive patient, and MON-29 from another HIV-infected patient. In each case, the same zymodeme was found in bone marrow and blood culture, both at initial diagnosis and at follow-up. These findings indicate that the minimally invasive hemoculture technique is an effective means of VL diagnosis in both HIV-infected and HIV-negative patients." @default.
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• W2142131853 date "1998-01-01" @default.
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• W2142131853 title "Haemoculture as a tool for diagnosing visceral leishmaniasis in HIV-negative and HIV-positive patients: interest for parasite identification." @default.
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