---
title: "Cutaneous leishmaniasis and HIV coinfection in Bolivian Amazonia: evolving presentation and treatm"
id: "pubmed-42600141"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42600141"
content_type: "clinical_feed_article"
specialty: "Infectious Disease"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42600141/"
doi: "10.1093/trstmh/trag096"
published_at: "2026-09-02T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Cutaneous leishmaniasis and HIV coinfection in Bolivian Amazonia: evolving presentation and treatm
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42600141
- **Specialty:** [Infectious Disease](https://medichelpline.com/clinical-feed/infectious-disease.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42600141/)
- **DOI:** [10.1093/trstmh/trag096](https://doi.org/10.1093%2Ftrstmh%2Ftrag096)
- **Published At:** 2026-09-02T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- A 34-year-old man with advanced **HIV** infection in Bolivian Amazonia initially presented with localized **cutaneous leishmaniasis**. - Initial therapy with pentavalent antimonials failed and the disease progressed from localized lesions to widespread dissemination with numerous ulcerated papules and nodules. - The patient developed systemic symptoms and important weight loss during progression. - Diagnostic testing included skin smears and histopathology, which demonstrated intracellular amastigotes consistent with leishmanial infection. - The confirmed diagnosis was intermediate cutaneous leishmaniasis with **HIV** coinfection; the report lists **Leishmania amazonensis** among keywords. - Sequential treatment with **liposomal amphotericin B** followed by oral **miltefosine** produced only transient clinical improvement. - The case highlights diagnostic and therapeutic difficulties of leishmaniasis in immunocompromised hosts, including atypical or changing clinical spectra and limited sustained response to standard antileishmanial regimens. - Authors emphasize the dynamic nature of clinical classification for cutaneous leishmaniasis in the setting of immunosuppression and the need for heightened awareness in endemic regions such as Bolivia.
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Affiliations Expand ### Affiliations * 1 Department of Dermatology, University Hospital "12 de Octubre", Madrid 28041, Spain. * 2 University of Barcelona, Campus de las Américas, Gran Via de les Corts Catalanes, 585, Barcelona 08007, Spain. * 3 Department of Pathology, University Hospital "12 de Octubre", Madrid 28041, Spain. * 4 Faculty of Medicine, Complutense University of Madrid, Pl. de Ramón y Cajal, 28040 Madrid, Spain. * 5 Investigación en Medicine Tropical y Salud Internacional de la Bio Regiones Bioliviana, Riberalta, Bolivia. * 6 Vector Borne Diseases of the Health Network 07, Riberalta, Bolivia. * 7 Universidad Autonoma del Beni, Riberalta, Bolivia. * PMID: **42600141** * DOI: [ 10.1093/trstmh/trag096 ](https://doi.org/10.1093/trstmh/trag096) Item in Clipboard Case Reports # The changing spectrum of cutaneous leishmaniasis and HIV coinfection in Bolivian Amazonia: a case report Alfonso Gotor-Rivera et al. Trans R Soc Trop Med Hyg. 2026. Show details Display options Display options Format Abstract PubMed PMID Trans R Soc Trop Med Hyg Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Trans+R+Soc+Trop+Med+Hyg%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Trans+R+Soc+Trop+Med+Hyg%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42600141/) . 2026 Sep 2;120(9):991-994. doi: 10.1093/trstmh/trag096. ### Authors [Alfonso Gotor-Rivera](https://pubmed.ncbi.nlm.nih.gov/?term=Gotor-Rivera+A&cauthor_id=42600141)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42600141/#short-view-affiliation-1 "Department of Dermatology, University Hospital "12 de Octubre", Madrid 28041, Spain."), [Mayber Lenin Aparicio-Loayza](https://pubmed.ncbi.nlm.nih.gov/?term=Aparicio-Loayza+ML&cauthor_id=42600141)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42600141/#short-view-affiliation-2 "University of Barcelona, Campus de las Américas, Gran Via de les Corts Catalanes, 585, Barcelona 08007, Spain."), [Rodrigo Federico Matilla Naumionek](https://pubmed.ncbi.nlm.nih.gov/?term=Naumionek+RFM&cauthor_id=42600141)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42600141/#short-view-affiliation-3 "Department of Pathology, University Hospital "12 de Octubre", Madrid 28041, Spain."), [José Luis Rodríguez Peralto](https://pubmed.ncbi.nlm.nih.gov/?term=Peralto+JLR&cauthor_id=42600141)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42600141/#short-view-affiliation-3 "Department of Pathology, University Hospital "12 de Octubre", Madrid 28041, Spain.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42600141/#short-view-affiliation-4 "Faculty of Medicine, Complutense University of Madrid, Pl. de Ramón y Cajal, 28040 Madrid, Spain."), [María René Melendres-Moscoso](https://pubmed.ncbi.nlm.nih.gov/?term=Melendres-Moscoso+MR&cauthor_id=42600141)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42600141/#short-view-affiliation-5 "Investigación en Medicine Tropical y Salud Internacional de la Bio Regiones Bioliviana, Riberalta, Bolivia."), [Yolanda López-Ochoa](https://pubmed.ncbi.nlm.nih.gov/?term=L%C3%B3pez-Ochoa+Y&cauthor_id=42600141)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42600141/#short-view-affiliation-6 "Vector Borne Diseases of the Health Network 07, Riberalta, Bolivia.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42600141/#short-view-affiliation-7 "Universidad Autonoma del Beni, Riberalta, Bolivia.") ### Affiliations * 1 Department of Dermatology, University Hospital "12 de Octubre", Madrid 28041, Spain. * 2 University of Barcelona, Campus de las Américas, Gran Via de les Corts Catalanes, 585, Barcelona 08007, Spain. * 3 Department of Pathology, University Hospital "12 de Octubre", Madrid 28041, Spain. * 4 Faculty of Medicine, Complutense University of Madrid, Pl. de Ramón y Cajal, 28040 Madrid, Spain. * 5 Investigación en Medicine Tropical y Salud Internacional de la Bio Regiones Bioliviana, Riberalta, Bolivia. * 6 Vector Borne Diseases of the Health Network 07, Riberalta, Bolivia. * 7 Universidad Autonoma del Beni, Riberalta, Bolivia. * PMID: **42600141** * DOI: [ 10.1093/trstmh/trag096 ](https://doi.org/10.1093/trstmh/trag096) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Case report:** A 34-year-old man with advanced HIV infection presented with localized cutaneous leishmaniasis, after unsuccessful trestment with pentavalent antimonials, progressive dissemination ocurred . On re-evaluation, he exhibited numerous widespread ulcerated papules and nodules , accompanied by systemic symptoms and significant weight loss. Skin smears and histopathology demonstrated intracellular amastigotes. A diagnosis of intermediate cutaneous leishmaniasis with HIV coinfection was established. Treatment with liposomal amphotericin B followed by oral miltefosine led only to transitory clinical resolution. **Discussion:** This case highlights the diagnostic and therapeutic challenges of leishmaniasis in immunocompromised patients and underscores the dynamic nature of the clinical classification of cutaneous leishmaniasis. **Keywords:** Leishmania amazonensis; cutaneous leishmaniasis; liposomal amphotericin B; miltefosine; pentavalent antimonial. © The Author(s) 2026. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. 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