Leishmania may diffusely involve the colon. It is usually associated with visceral leishmaniasis but may be the presenting complaint.
Clinical features:
(1) severe immunosuppression (AIDS, transplant, etc), rarely immunocompetent
(2) diarrhea with or without blood
(3) pancytopenia
(4) hepatosplenomegaly
(5) weight loss
(6) variable malabsorption
(7) hyperemia and friability of colonic mucosa with nodularity and/or ulceration
(8) presence of amastigote forms within macrophages and/or positive PCR
(9) exclusion of other causes of colitis
Some things that may be negative or absent:
(1) fever
(2) serologic tests for anti-leishmania antibodies
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Specialty: Infectious Diseases
