Инфекционная патология в практике врача-гематолога: висцеральный лейшманиоз у ВИЧ-инфицированного пациента

The clinical case of visceral leishmaniasis and HIV coinfection, associated with bone marrow involvement, which is uncommon in Siberia, was demonstrated. The detailed literature review on the issue was given. The data analysis of leishmaniasis prevalence dynamics in northern latitudes was conducted and the features of disease epidemiology were highlighted. The clinical forms of this parasite invasion and the contemporary ideas about mechanism of lieshmania escape from phagocytosis were described on the basis of recent data. The algorithm of differential diagnosis, diagnosis criterions and treatment standards were developed. The comprehensive approach to diagnosis and management of the zoonosis and HIV coinfection were described. The disease hematological features such as pancytopenia, lymphadenopathy, hepatosplenomegaly and fever were revealed. The significant of bone marrow hematopoiesis examination in leishmaniasis was specified. The analysis of the literature on the transformation of modern visceral leishmaniasis was carried out: an increase in the number of erased clinical debut forms, an increase in the duration of the latent period of the disease up to 130–160 days after transfection, an increase in the role of immunodepression factors in the clinical manifestation of the disease. The data on the epidemiological sources of zoonosis - insect vectors, conditions of infection, methods of prevention have been performed.